China
Africa
Explore chapters and articles related to this topic
Point-of-Care Ultrasound
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
Procedure:Identify the anatomy of the insertion site and localization of the artery or vein.Confirm and place a catheter in the artery or vein (e.g. central line/dialysis catheter/arterial line).
Assessing and responding to sudden deterioration in the adult
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
An arterial line is inserted into an artery. As with central lines, this is an invasive procedure with potential complications, many of which are similar to those associated with central lines. The main reason for inserting an arterial line is to allow continuous arterial blood pressure monitoring and arterial blood sampling. Arterial BP recordings have greater accuracy than the non-invasive methods for BP recording (Pierre and Keenaghan 2020). This is due to arterial lines allowing direct measurement via the cannula placed in the artery. A variety of arterial sites may be used to achieve this recording (e.g. radial, brachial and femoral). This is an advanced skill carried out by qualified practitioners; however, you may be required to assist with this procedure.
Complications of open thoracoabdominal aortic aneurysm repair
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
In the operating room, the patient's airway is secured with a double-lumen endotracheal tube for extent I–III aneurysms, which require extensive entry into the left hemithorax and left lung isolation to expose the proximal descending thoracic aorta. After the patient is asleep, somatosensory motor-evoked potential monitoring (SSMEVP) probes are secured, and a central line, typically in the right internal jugular vein, with pulmonary artery (Swan-Ganz) catheter is placed. The anesthesia team is reminded that any paralytics used during induction and exposure should be short-acting as to not interfere with SSMEVP once the aortic cross clamp is placed later in the case. A nasogastric tube is placed in supine position. Finally, a right femoral arterial line is placed sterilely by a member of the surgical team. This is performed with micropuncture access under ultrasound guidance followed by insertion of a 4 or 5F sheath over a 3J wire. The sheath is sutured to the skin and the prepped area is covered with a piece of Ioban to maintain sterility in the rare event when access to the right groin is required during the operation.
Risk factors influence the arterial line patency in ICU-bound patients during COVID-19 pandemic: An observational cohort study
Published in Egyptian Journal of Anaesthesia, 2023
Hamed Elgendy, Adel Ganaw, Vipin Kumari, Vijay Settu, Prem Chandra, Hanaa Nafady-Hego, Mohamad Hilani, Hesham Ismail, Mohamed Elkateeb
Platelets per 100.000 increase escalated the risk of arterial line failure (HR 1.40; 95% CI 1.12–1.74; p = 0.003). Blind technique versus ultrasound use in arterial line insertion exhibited more than four times increase risk of arterial line failure (HR 4.12; 95% CI 1.60–10.67; p = 0.003). Prone position in ICU had more than double the risk of arterial line failure than patients with supine position (HR 2.07; 95% CI 1.180–3.63; p = 0.011). Deaths within the first 45 days after arterial line insertion and its cause according to systemic anticoagulation and non-systemic anticoagulation were compared. There were increased percentages of cases with renal failure (83.3), heart failure, (83.3), p = 0.019 and p < 0.0001 in group of non-systemic anticoagulation, respectively as shown in Table 5. Deaths within the first 45 days after arterial line insertion and its reasons according to the failure of arterial line were analyzed. There were insignificant differences in mortality risk between patent and failed arterial lines as shown in Table 6.
A 29-year-old woman presenting for urgent cesarean hysterectomy: a multidisciplinary care challenge
Published in Baylor University Medical Center Proceedings, 2023
Claudia Serrano, Jessica C. Ehrig, Michael P. Hofkamp
The placenta accreta team was rapidly assembled, consisting of an accreta surgeon; members from urology, anesthesiology, and neonatology services; and operating room circulator nurses and surgical technicians. A standardized cesarean hysterectomy checklist was used to direct care. When the patient arrived in the operating room, an arterial line was placed for continuous blood pressure monitoring. More than 12 hours had elapsed since her last dose of enoxaparin, and she received a combined spinal epidural with 11.25 mg hyperbaric bupivacaine 0.75%, 15 mcg of fentanyl, and 0.2 mg of preservative-free morphine administered in the intrathecal space. Bilateral ureteral stents were then placed by an urologist. An abdominal incision was made and the fascia and recti muscles were separated. Ultrasound mapping of the uterus using a sterile probe cover was performed to identify a site for uterine incision that would avoid the placenta. The neonate was delivered and neonatal care was provided by the neonatology team in attendance. Apgar scores were 8 and 9 at 1 and 5 minutes, respectively. After delivery of the neonate, general endotracheal anesthesia was induced. A supracervical hysterectomy was performed and was complicated by extensive adhesions from the anterior abdominal wall to anterior uterus. The patient received a bilateral transversus abdominus plane block under ultrasound guidance prior to emergence to facilitate postoperative analgesia.
Preoperative left stellate ganglion block: Does it offer arrhythmia-protection during off-pump CABG surgery? A randomized clinical trial
Published in Egyptian Journal of Anaesthesia, 2020
Essam Abd Allah, Mohammed Abdelmonem Bakr, Sara Abdallah Abdelrahman, Ahmed M. Taha, Emad Zarief Kamel
Before induction, arterial line was placed under local anesthesia. Induction was achieved by fentanyl (3–4 µg/kg) and propofol (1–2 mg/kg), followed by cisatracurium (0.15 mg/kg) to facilitate endotracheal intubation, then volume-controlled ventilation was instituted with parameters set to maintain normocarbia. Central venous pressure line was applied in the right internal jugular vein. Anesthesia was maintained by isoflurane in oxygen and air (FiO2 = 0.5), fentanyl infusion (1 µg/kg/hour), and cisatracurium infusion (1–2 µg/kg/min) for maintenance of muscle relaxation. Intraoperative monitoring included electrocardiogram, invasive systemic blood pressure, central venous pressure, O2 saturation by pulse oximetry, end-tidal CO2 by capnography, arterial blood gases, core body temperature using nasopharyngeal probe, and urine output. Operative procedure was done through midline sternotomy and by the same surgical team.