scholarly journals Establishing a Nurse-Led Central Venous Catheter Insertion Service

2010 ◽  
Vol 15 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Evan Alexandrou ◽  
Tim Spencer ◽  
Steven A. Frost ◽  
Michael Parr ◽  
Patricia M. Davidson ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Best Practice ◽  
Evaluation Method ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Successful Implementation ◽  
Medical Procedure ◽  
Central Venous ◽  
Medical Practitioners

Abstract Background: Health care systems promote care models that deliver both safety and quality. Nurse-led vascular access teams show promise as a model to achieve hospital efficiencies and improve patient outcomes. Objectives: The aim of this paper is to discuss the process of establishing a nurse-led central venous catheter (CVC) insertion service in a university affiliated hospital using a process evaluation method. Method: Archival information, including reports, communications and minutes of departmental meetings were reviewed. Key stakeholders involved in establishing this nurse-led service at the time were interviewed. Results: A nurse-led CVC insertion service was first established in 1996 and has increased in service provision over 13 years. Initially there was scepticism from some medical practitioners about the feasibility of a nurse performing a traditional medical procedure. The service currently provides central venous access across the hospital including critical care areas. The service places up to 500 catheters per annum. Conclusions: Establishing a nurse-led CVC insertion service has increased organizational efficiencies and provided an infrastructure for support of best practice. The support of senior management and medical practitioners was crucial to the successful implementation of this model of care.

scholarly journals Central Venous Catheter induced Atrial Fibrillation-A Case Report

2021 ◽  
Vol 39 (3) ◽  
pp. 200-204
Author(s):  
Masud Ahmed ◽  
Azizun Nessa ◽  
Md Al Amin Salek
Keyword(s):  
Atrial Fibrillation ◽  
Central Venous Catheter ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Cardiac Complications ◽  
Haemodynamic Instability ◽  
Central Venous ◽  
Common Procedure ◽  
Dc Cardioversion

Though a common procedure, central venous access is related to morbidity and mortality of patients. Common cardiac complications caused by central venous catheters include premature atrial and ventricular contractions. But development of atrial fibrillation with haemodynamic instability is quite rare. We are reporting a patient who developed atrial fibrillation with hypotension while inserting central venous catheter through right subclavian vein by landmark technique. Patient was managed with DC cardioversion. Careful insertion of central venous catheter & prompt management of its complication is crucial to avoid catastrophe. J Bangladesh Coll Phys Surg 2021; 39(3): 200-204

scholarly journals Linezolid lock prophylaxis of central venous catheter infection

2008 ◽  
Vol 57 (4) ◽  
pp. 534-535 ◽  
Author(s):  
Jérôme Patrick Fennell ◽  
Martin O'Donohoe ◽  
Martin Cormican ◽  
Maureen Lynch
Keyword(s):  
Central Venous Catheter ◽  
Hospital Admissions ◽  
Blood Stream Infection ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Blood Stream ◽  
Central Venous ◽  
Central Venous Catheter Infection ◽  
The Impact

Central venous catheter (CVC)-related infections are a major problem for patients requiring long-term venous access and may result in frequent hospital admissions and difficulties in maintaining central venous access. CVC-related blood stream infections are associated with increased duration of inpatient stay and cost approximately \#8364;13 585 per patient [Blot, S. I., Depuydt, P., Annemans, L., Benoit, D., Hoste, E., De Waele, J. J., Decruyenaere, J., Vogelaers, D., Colardyn, F. & Vandewoude, K. H. (2005). Clin Infect Dis 41, 1591–1598]. Antimicrobial lock therapy may prevent CVC-related blood stream infection, preserve central venous access and reduce hospital admissions. In this paper, the impact of linezolid lock prophylaxis in a patient with short bowel syndrome is described.

Placement of Central Venous Catheters in Patients Undergoing Major Maxillofacial Surgery - A Retrospective Clinical Audit

2010 ◽  
Vol 11 (2) ◽  
pp. 128-131
Author(s):  
Vasileios Zochios ◽  
Michael Gilhooly ◽  
Simon Fenner
Keyword(s):  
Central Venous Catheter ◽  
Superior Vena Cava ◽  
Superior Vena ◽  
Central Venous Access ◽  
Maxillofacial Surgery ◽  
Vena Cava ◽  
Venous Catheter ◽  
Venous Access ◽  
Central Venous Catheters ◽  
Central Venous

Purpose The subclavian vein is thought to be the most appropriate route for central venous access in major maxillofacial surgery. Evidence suggests that left-sided central venous catheters should lie below the carina and be angulated at less than 40° to superior vena cava wall. This reduces perforation risk. With this in mind we audited our current practice for placement of central venous catheters for major maxillofacial surgery. The criteria against which we compared our practice were: 1) all catheter tips should lie below the carina and 2) the angle of the distal 1 cm of the catheter should be no more than 40° to the superior vena cava wall. Methods Left subclavian central venous catheters placed on a weekly operating list between September 2005 and August 2008 were identified retrospectively: 83 patients were identified; 22 were excluded. The angle of the central venous catheter tip and distance from the carina were measured on the first post-procedure chest-X ray. All central venous catheters used were 16 cm long. Results 82% of the catheter tips were located above the carina while 61% were angulated at greater than 40°; 11% of central venous catheters met both standards; 14% of central venous catheters placed by a consultant and 12% of catheters placed by a trainee met both standards. Conclusions 89% of the central venous catheters were not correctly placed. The majority of central venous catheter tips above the carina were at an adverse angle to the superior vena cava wall. We suggest that for left subclavian central lines, 20 cm catheters be used.

scholarly journals Delphi Method to Achieve Clinical Consensus for a BPMN Representation of the Central Venous Access Placement for Training Purposes

2020 ◽  
Vol 17 (11) ◽  
pp. 3889
Author(s):  
Rene de la Fuente ◽  
Ricardo Fuentes ◽  
Jorge Munoz-Gama ◽  
Jorge Dagnino ◽  
Marcos Sepúlveda
Keyword(s):  
Delphi Method ◽  
Online Survey ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Medical Procedure ◽  
Initial Model ◽  
Central Venous ◽  
Medical Specialties ◽  
Decision Points

Proper teaching of the technical skills necessary to perform a medical procedure begins with its breakdown into its constituent steps. Currently available methodologies require substantial resources and their results may be biased. Therefore, it is difficult to generate the necessary breakdown capable of supporting a procedural curriculum. The aim of our work was to breakdown the steps required for ultrasound guided Central Venous Catheter (CVC) placement and represent this procedure graphically using the standard BPMN notation. Methods: We performed the first breakdown based on the activities defined in validated evaluation checklists, which were then graphically represented in BPMN. In order to establish clinical consensus, we used the Delphi method by conducting an online survey in which experts were asked to score the suitability of the proposed activities and eventually propose new activities. Results: Surveys were answered by 13 experts from three medical specialties and eight different institutions in two rounds. The final model included 28 activities proposed in the initial model and four new activities proposed by the experts; seven activities from the initial model were excluded. Conclusions: The proposed methodology proved to be simple and effective, generating a graphic representation to represent activities, decision points, and alternative paths. This approach is complementary to more classical representations for the development of a solid knowledge base that allows the standardization of medical procedures for teaching purposes.

Central Venous Catheter Placement Using the Seldinger Technique

2021 ◽  
pp. 55-64
Author(s):  
Kirk Lalwani ◽  
Philip W. Yun
Keyword(s):  
Central Venous Catheter ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Catheter Placement ◽  
Seldinger Technique ◽  
Central Venous ◽  
Rapid Infusion ◽  
Patient Factors ◽  
Central Venous Catheter Placement

Chapter 6 covers central venous catheter placement, which is often performed for major procedures or in critical pediatric patients. Indications include hemodynamic monitoring, administration of hyperosmolar medications, hemodialysis, and rapid infusion of fluids. Internal jugular, subclavian, and femoral veins are commonly used for central venous access. In the pediatric patient, factors that influence the site of placement include age, likely duration of use, operator expertise, and the need for sedation. After the site of placement is determined, optimal positioning of the patient and meticulous technique are paramount to increase the chance for success. The Seldinger technique is the preferred method for catheterizing the vein following needle venipuncture and is outlined step-by-step in this chapter.

Central Venous Catheter Complications

PEDIATRICS ◽  
1983 ◽  
Vol 71 (5) ◽  
pp. 865-865
Author(s):  
DENNIS J. HOELZER ◽  
CHARLES S L'HOMMEDIEU
Keyword(s):  
Central Venous Catheter ◽  
Success Rate ◽  
Central Venous Access ◽  
Venous Catheter ◽  
Venous Access ◽  
Technical Expertise ◽  
Central Venous ◽  
Catheter Complications ◽  
Central Venous Catheter Complications

To the Editor.— We read with interest the paper of Dolcourt and Bose.1 We commend them on their technical expertise and success rate in establishing central venous access. There are several conclusions with which we take issue. 1. Duration of Line Usage. The authors report that their catheters remained in place for a mean of 24.8 days (variance of 15.9 days). More informative would be median days of usage. They compare their results with other reports and claim that their catheters lasted twice as long.

Hybrid angioplasty-catheter placement procedure performed in a hemodialysis patient with central venous obstruction disease. Presentation of a case

2020 ◽  
pp. 112972982098318
Author(s):  
Nikolaos Ptohis ◽  
Panagiotis G Theodoridis ◽  
Ioannis Raftopoulos
Keyword(s):  
Therapeutic Option ◽  
Central Venous Access ◽  
Major Complication ◽  
Venous Catheter ◽  
Venous Access ◽  
Transluminal Angioplasty ◽  
Catheter Placement ◽  
Venous Disease ◽  
Central Venous ◽  
Brachiocephalic Trunk

Obstruction or occlusion of the central veins (Central venous disease, CVD) represents a major complication in hemodialysis patients (HD) limiting central venous access available for a central venous catheter placement. Endovascular treatment with percutaneous transluminal angioplasty (PTA) is the first therapeutic option to restore patency and gain access. This case presents our initial experience of a HD patient with CVD treated with a combination therapy of a balloon PTA to the left brachiocephalic trunk, through the right hepatic vein and standard catheter placement technique to the previously occluded junction of the left internal jugular vein to the left subclavian vein.

scholarly journals Guide-wire replacement of a mini-midline catheter with a central venous catheter: A retrospective study on 63 cases

2020 ◽  
pp. 112972982094406
Author(s):  
Lucio Brugioni ◽  
Elisabetta Bertellini ◽  
Mirco Ravazzini ◽  
Marco Barchetti ◽  
Andrea Borsatti ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Guide Wire ◽  
Case Series ◽  
Venous Catheter ◽  
Venous Access ◽  
Late Complications ◽  
Central Catheter ◽  
Central Venous ◽  
Single Lumen ◽  
Thrombotic Complications

Background: Achieving a reliable venous access in a particular subset of patients and/or in emergency settings can be challenging and time-consuming. Furthermore, many hospitalized patients do not meet the criteria for central venous catheter positioning, unless an upgrade of the treatment is further needed. The mini-midline catheter has already showed to be reliable and safe as a stand-alone device, since it is easily and rapidly inserted and can indwell up to 1 month. Methods: In this further case series, we retrospectively evaluated data from 63 patients where a previously inserted mini-midline catheter was upgraded to a central venous catheter (the devices inserted in the arm replaced by peripherally inserted central catheter and others inserted “off-label” in the internal jugular replaced by single lumen centrally inserted central catheter), being used as introducer for the Seldinger guidewire. Results: The guidewire replacement was been made even early (after 1 day) or late (more than 10 days), usually following a need for an upgrade in treatment. No early or late complications were reported. Conclusion: According to the preliminary data we collected, this converting procedure seems to be feasible and risk-free, since neither infectious nor thrombotic complications were reported.

scholarly journals Folded large-bore central catheter in the right internal jugular vein as shown by ultrasound: a case report

2018 ◽  
Vol 47 (2) ◽  
pp. 1005-1009
Author(s):  
Taehee Pyeon ◽  
Jeong-Yeon Hwang ◽  
HyungYoun Gong ◽  
Sang-Hyun Kwak ◽  
Joungmin Kim
Keyword(s):  
Central Venous Catheter ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Present Report ◽  
Large Diameter ◽  
Venous Catheter ◽  
Venous Access ◽  
Central Venous ◽  
The Right ◽  
Gain Access

Central venous catheters are used for various purposes in the operating room. Generally, the use of ultrasound to insert a central venous catheter is rapid and minimally complicated. An advanced venous access (AVA) catheter is used to gain access to the pulmonary artery and facilitate fluid resuscitation through the internal jugular vein. The present report describes a case in which ultrasound was used in a 43-year-old man to avoid complications during insertion of an AVA catheter with a relatively large diameter. The sheath of the catheter was so thin that a dilator was essential to prevent it from folding upon insertion. Despite the use of ultrasound guidance, the AVA catheter sheath became folded within the patient’s internal jugular vein. Mechanical complications of central venous catheter insertion are well known, but folding of a large-bore catheter in the internal jugular vein has rarely been reported.

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