Indications for central venous cannulation in critically ill patients have increased dramatically, but central venous access has the drawbacks of morbidity and a scarcity of experienced operators. Ultrasound-guided peripheral venous access offers a solution, in that it reduces morbidity and can be performed by a dedicated nursing team. The aim of this book is to teach the fundamentals of this emerging technique. Advice is provided on choice of materials; maneuvers for positioning of peripherally inserted central venous catheters (PICCs), techniques for evaluation of PICC tip placement; prevention, diagnosis, and management of complications; and organization of a dedicated team within a hospital or a supportive care program. Legal and economic issues are also considered. The book will be of interest to a wide range of professionals, including nutritionists, oncologists, anesthesiologists, surgeons, registered nurses, nurse practitioners, physicians, physician assistants, and radiologists.

This Open access book offers updated and revised information on vessel health and preservation (VHP), a model concept first published in poster form in 2008 and in JVA in 2012, which has received a great deal of attention, especially in the US, UK and Australia. The book presents a model and a new way of thinking applied to vascular access and administration of intravenous treatment, and shows how establishing and maintaining a route of access to the bloodstream is essential for patients in acute care today. Until now, little thought has been given to an intentional process to guide selection, insertion and management of vascular access devices (VADs) and by default actions are based on crisis management when a quickly selected VAD fails. The book details how VHP establishes a framework or pathway model for each step of the patient experience, intentionally guiding, improving and eliminating risk when possible. The evidence points to the fact that reducing fragmentation, establishing a pathway, and teaching the process to all stakeholders reduces complications with intravenous therapy, improves efficiency and diminishes cost. As such this book appeals to bedside nurses, physicians and other health professionals.

This book addresses all the issues a patient may experience prior to receiving a VAD. Selection of equipment, practical aspects of technique, the pros and cons of the various veins, and modifications of technique for certain circumstances are examined. Covereage also includes the roles played by radiologists, anaesthetists, surgeons, nurses, and other team memebers. Throughout the chapters a reference is made to the IV Therapy Standards published by the Royal College of Nursing IV Therapy Forum in 2003. Each chapter is evidence based and fully referenced.

Since their first application in 1982, Totally Implantable Venous Access Devices (TIVADs) have become increasingly important in the clinical practice, as more intensive chemotherapy and parenteral treatments have come into use. At this time, there is objective evidence that TIVADs are a safe, effective strategy for long-term venous access; they play a significant role throughout the management of the oncology patient, as they are needed in the initial phases for active treatments as well as in the last stages for palliative measures, making possible repeated administration of chemotherapeutic vesicant agents, nutrients, antibiotics, analgesics, and blood products. According to a number of prospective studies, use of TIVADs is associated with a significant complication rate (10% to 25% of all patients). Evidence-based data support that most complications are directly related to inappropriate technique of placement and/or nursing care, sometimes leading to TIVAD loss, significant morbidity, increased duration of hospitalization, and additional medical cost. A group of world-renowned experts - both in the clinical and research fields – contributed to this volume, whose aim is to provide clinicians, nurses and medical students with a multidisciplinary, full update on these devices, as long term central venous access can no be longer considered a routine matter, and serious complications can be maintained at a very low level only if strict adherence to a well-defined protocol of surgical technique and of catheter care is maintained.

Venous access devices are necessary for any patient requiring repeated blood sampling, parenteral nutrition, chemotherapy, antibiotic therapy or other IV treatments to be delivered in the hospital setting or at home. In the last decade, ultrasound-guided PICCs and Midline catheters – inserted by adequately trained physicians or nurses - have suddenly and widely spread in the field of venous access devices all over the world. The introduction and diffusion of PICCs in Italy has been historically linked to the GAVeCeLT association (the Italian Group of Long Term Venous Access Devices) and particularly to the authors’ scientific and didactic activity. This volume examines the clinical indications for these devices and illustrates the details of their insertion and management in several clinical settings. Furthermore, all the specifications regarding the materials to use and all the aspects related to device removal and replacement, as well as the different strategies for complications prevention, are thoroughly discussed.

Completely revised to reflect recent, rapid changes in the field of interventional radiology (IR), Image-Guided Interventions, 3rd Edition, offers comprehensive, narrative coverage of vascular and nonvascular interventional imaging—ideal for IR subspecialists as well as residents and fellows in IR. This award-winning title provides clear guidance from global experts, helping you formulate effective treatment strategies, communicate with patients, avoid complications, and put today's newest technology to work in your practice. - Offers step-by-step instructions on a comprehensive range of image-guided intervention techniques, including discussions of equipment, contrast agents, pharmacologic agents, antiplatelet agents, and classic signs, as well as detailed protocols, algorithms, and SIR guidelines. - Includes new chapters on Patient Preparation, Prostate Artery Embolization, Management of Acute Aortic Syndrome, Percutaneous Arterial Venous Fistula Creation, Lymphatic Interventions, Spinal and Paraspinal Nerve Blocks, and more. - Employs a newly streamlined format with shorter, more digestible chapters for quicker reference. - Integrates new patient care and communication tips throughout to address recent changes in practice. - Highlights indications and contraindications for interventional procedures, and provides tables listing the materials and instruments required for each. - Features more than 2,300 state-of-the-art images demonstrating IR procedures, full-color illustrations of anatomical structures and landmarks, and video demonstrations online. - 2014 BMA Medical Book Awards Highly Commended in Radiology category!

Committed to providing safe anaesthetic care for paediatric patients, it is of paramount importance for clinicians to learn from suboptimal situations in order to continuously improve clinical performance. The first resource of its kind, this text analyses a selection of fascinating case studies and evaluates best practice in providing safe anaesthesia to children with recommendations on how to avoid the most common clinical pitfalls. Featuring over seventy chapters, topics include airway-related problems, vascular access, regional anaesthesia, medication related problems and the management of patients with pre-existing conditions. Each case study is supported by full colour images, making this essential reading for consultants and trainees in anaesthesia.

Organised along an organ and systems basis, this comprehensive reference source covers all diagnostic and interventional imaging techniques and modalities in an integrated, correlative fashion.

Infections are among the most frequent complications in patients with hematological malignancies and in those undergoing high-dose chemotherapy and autologous hematopoietic stem cell transplantation. A profound knowledge on the epidemiology, diagnostic approaches, treatment modalities and prophylactic strategies is essential for the clinical management of these complications in patients who are often severely immunocompromised owing to their underlying diseases and in particular, the intensive myelosuppressive chemo and immunotherapy. This textbook provides a clinically oriented, compact and up-to-date overview on infections in hematology patients and their management. The typical pathogens to be considered in different subgroups of patients are identified and further aspects of the microbiological background are explored. Clinical, imaging, and laboratory-based diagnostic techniques are discussed and therapeutic strategies appropriate to different situations are then presented, with due attention to the pitfalls, toxicities and interactions that can arise during antimicrobial treatment. Strategies to prevent infection are also outlined, encompassing antimicrobial prophylaxis, isolation procedures, hospital hygiene, protective immunization and the use of hematopoietic growth factors.