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 practical and comprehensive book provides "how-to" information on all aspects of access to the vascular system for hemodialysis, parenteral nutrition, chemotherapy, and resuscitation. Preoperative evaluation, operations, noninvasive procedures, complications, and other aspects are detailed. This edition provides increased coverage of non-interventional techniques and includes new chapters on management of thrombophilia in hemodialysis patients; modulation of the immune system to prevent myointimal hyperplasia; synthetic grafts; venous outflow stenting for salvage of vascular access procedures; and ultrasound in vascular access procedures. This book is essential for all clinicians treating patients who require vascular access, including vascular surgeons, general surgeons, nephrologists, dialysis technicians and nurses, radiologists, and cardiologists.

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 is the second edition of the WHO handbook on the safe, sustainable and affordable management of health-care waste--commonly known as "the Blue Book". The original Blue Book was a comprehensive publication used widely in health-care centers and government agencies to assist in the adoption of national guidance. It also provided support to committed medical directors and managers to make improvements and presented practical information on waste-management techniques for medical staff and waste workers. It has been more than ten years since the first edition of the Blue Book. During the intervening period, the requirements on generators of health-care wastes have evolved and new methods have become available. Consequently, WHO recognized that it was an appropriate time to update the original text. The purpose of the second edition is to expand and update the practical information in the original Blue Book. The new Blue Book is designed to continue to be a source of impartial health-care information and guidance on safe waste-management practices. The editors' intention has been to keep the best of the original publication and supplement it with the latest relevant information. The audience for the Blue Book has expanded. Initially, the publication was intended for those directly involved in the creation and handling of health-care wastes: medical staff, health-care facility directors, ancillary health workers, infection-control officers and waste workers. This is no longer the situation. A wider range of people and organizations now have an active interest in the safe management of health-care wastes: regulators, policy-makers, development organizations, voluntary groups, environmental bodies, environmental health practitioners, advisers, researchers and students. They should also find the new Blue Book of benefit to their activities. Chapters 2 and 3 explain the various types of waste produced from health-care facilities, their typical characteristics and the hazards these wastes pose to patients, staff and the general environment. Chapters 4 and 5 introduce the guiding regulatory principles for developing local or national approaches to tackling health-care waste management and transposing these into practical plans for regions and individual health-care facilities. Specific methods and technologies are described for waste minimization, segregation and treatment of health-care wastes in Chapters 6, 7 and 8. These chapters introduce the basic features of each technology and the operational and environmental characteristics required to be achieved, followed by information on the potential advantages and disadvantages of each system. To reflect concerns about the difficulties of handling health-care wastewaters, Chapter 9 is an expanded chapter with new guidance on the various sources of wastewater and wastewater treatment options for places not connected to central sewerage systems. Further chapters address issues on economics (Chapter 10), occupational safety (Chapter 11), hygiene and infection control (Chapter 12), and staff training and public awareness (Chapter 13). A wider range of information has been incorporated into this edition of the Blue Book, with the addition of two new chapters on health-care waste management in emergencies (Chapter 14) and an overview of the emerging issues of pandemics, drug-resistant pathogens, climate change and technology advances in medical techniques that will have to be accommodated by health-care waste systems in the future (Chapter 15).

Estimation of the Time Since Death remains the foremost authoritative book on scientifically calculating the estimated time of death postmortem. Building on the success of previous editions which covered the early postmortem period, this new edition also covers the later postmortem period including putrefactive changes, entomology, and postmortem r

This presentation describes various aspects of the regulation of tissue oxygenation, including the roles of the circulatory system, respiratory system, and blood, the carrier of oxygen within these components of the cardiorespiratory system. The respiratory system takes oxygen from the atmosphere and transports it by diffusion from the air in the alveoli to the blood flowing through the pulmonary capillaries. The cardiovascular system then moves the oxygenated blood from the heart to the microcirculation of the various organs by convection, where oxygen is released from hemoglobin in the red blood cells and moves to the parenchymal cells of each tissue by diffusion. Oxygen that has diffused into cells is then utilized in the mitochondria to produce adenosine triphosphate (ATP), the energy currency of all cells. The mitochondria are able to produce ATP until the oxygen tension or PO2 on the cell surface falls to a critical level of about 4–5 mm Hg. Thus, in order to meet the energetic needs of cells, it is important to maintain a continuous supply of oxygen to the mitochondria at or above the critical PO2 . In order to accomplish this desired outcome, the cardiorespiratory system, including the blood, must be capable of regulation to ensure survival of all tissues under a wide range of circumstances. The purpose of this presentation is to provide basic information about the operation and regulation of the cardiovascular and respiratory systems, as well as the properties of the blood and parenchymal cells, so that a fundamental understanding of the regulation of tissue oxygenation is achieved.

Designed for health care professionals in multiple disciplines and clinical settings, this comprehensive, evidence-based wound care text provides basic and advanced information on wound healing and therapies and emphasizes clinical decision-making. The text integrates the latest scientific findings with principles of good wound care and provides a complete set of current, evidence-based practices. This edition features a new chapter on wound pain management and a chapter showing how to use negative pressure therapy on many types of hard-to-heal wounds. Technological advances covered include ultrasound for wound debridement, laser treatments, and a single-patient-use disposable device for delivering pulsed radio frequency.

Cardiovascular Pathology, Fourth Edition, provides users with a comprehensive overview that encompasses its examination, cardiac structure, both normal and physiologically altered, and a multitude of abnormalities. This updated edition offers current views on interventions, both medical and surgical, and the pathology related to them. Congenital heart disease and its pathobiology are covered in some depth, as are vasculitis and neoplasias. Each section has been revised to reflect new discoveries in clinical and molecular pathology, with new chapters updated and written with a practical approach, especially with regards to the discussion of pathophysiology. New chapters reflect recent technological advances with cardiac devices, transplants, genetics, and immunology. Each chapter is highly illustrated and covers contemporary aspects of the disease processes, including a section on the role of molecular diagnostics and cytogenetics as specifically related to cardiovascular pathology. Customers buy the Print + Electronic product together! Serves as a contemporary, all-inclusive guide to cardiovascular pathology for clinicians and researchers, as well as clinical residents and fellows of pathology, cardiology, cardiac surgery, and internal medicine Offers new organization of each chapter to enable uniformity for learning and reference: Definition, Epidemiology, Clinical Presentation, Pathogenesis/Genetics, Light and Electron Microscopy/Immunohistochemistry, Differential Diagnosis, Treatment and Potential Complications Features six new chapters and expanded coverage of the normal heart and blood vessels, cardiovascular devices, congenital heart disease, tropical and infectious cardiac disease, and forensic pathology of the cardiovascular system Contains 400+ full color illustrations and an online image collection facilitate research, study, and lecture slide creation

Conserving health in early modern culture explores the impact of ideas about healthy living in early modern England and Italy. The attention of medical historians has largely been focussed on the study of illness and medical treatment, yet prevention was one of the cornerstones of early modern medicine. According to Galenic-Hippocratic thought, the preservation of health depended on the careful management of the so-called six ?Non-Naturals?: the air one breathed; food and drink; excretions; sleep; movement and rest; and emotions. Drawing on visual, material and textual sources, the contributors show the pervasiveness of the preventive paradigm in early modern culture and society. In particular it becomes apparent that concern for the non-naturals informed lay people?s daily lives and routines as well as stimulating innovation in material culture and painting, and influencing discourses in fields as diverse as geology, natural philosophy and religion. At the same time the volume challenges the common assumption that health advice was a uniform and stable body of knowledge, showing instead that models of healthy living were tailored to different genders, age-groups and categories of patients; they also varied over time and depended on the geographical context. In particular, significant differences emerge between what was regarded as beneficial or harmful to health in England and Italy. As well as showing the value of a comparative perspective of study, this interdisciplinary volume will appeal to a wide readership, interested not just in health practices, but in print culture, histories of women, infancy, the environment and of art and material culture.