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Central Venous Access in Trauma Bay
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
Anjuman Chander, Ashish Aditya, Tanvir Samra, Harshit Singla
There are three main sites that have been explored for central venous catheterization. They are the internal jugular vein (IJV), subclavian vein (SCV) and femoral vein (FV). Each of these sites has its own advantages and disadvantages (Table 15.1).
Catheter-Related Infections
Published in Stephen M. Cohn, Alan Lisbon, Stephen Heard, 50 Landmark Papers, 2021
Central venous catheters are essential for the care of the critically ill patient. Mechanical and infectious complications are the most common complications associated with central venous catheterization. Early efforts to reduce catheter infection included scheduled removal and reinsertion of the catheter at a different site and or scheduled exchange of the catheter by a new one over a guide wire. Although initial reports touted the efficacy of these approaches, neither strategy was found to be helpful in reducing central line associated bloodstream infections (CLABSIs). Guide wire exchange should only be performed if a catheter is malfunctioning and no infection is suspected.
Prevention of Central Line–Associated Bloodstream Infections
Published in Stephen M. Cohn, Peter Rhee, 50 Landmark Papers, 2019
Central venous catheters are essential for the care of the critically ill patient. Mechanical and infectious complications are the most common complications associated with central venous catheterization. Early efforts to reduce catheter infection included scheduled removal and reinsertion of the catheter at a different site and/or scheduled exchange of the catheter for a new one over a guidewire. Although initial reports touted the efficacy of these approaches, neither strategy was found to be helpful in reducing central line–associated bloodstream infections (CLABSIs).
Double superior vena cava: presentation of two cases and review of the literature
Published in Acta Chirurgica Belgica, 2019
Christos Farazi-Chongouki, Ioannis Dalianoudis, Anestis Ninos, Pantelis Diamantopoulos, Dimitrios Filippou, Stefanos Pierrakakis, Panagiotis Skandalakis
The clinical significance of left SVC varies and depends on the existence or lack of symptoms and other congenital heart disease. It can affect the clinicians in imaging diagnosis, central venous catheterization and surgery. Since McCotter first reported three cases in 1916 [8], there were several cases published (Table 1). Steinberg et al. suggested a classification of persistence left superior vena cava into three groups: (1) bilateral superior vena cava without congenital cardiac anomalies, (2) bilateral superior vena cava with associated congenital cardiac anomalies and (3) absence of the right superior vena cava [8].
Overlooked guide wire: a multicomplicated Swiss Cheese Model example. Analysis of a case and review of the literature
Published in Acta Clinica Belgica, 2020
Henri Thonon, Florence Espeel, Ficart Frederic, Frédéric Thys
Central venous catheterization must be carried out by experienced people. If the operator’s experience is insufficient, careful supervision must be carried out by an expert. Every health professional involved in the procedure must be focused on this unique task. In addition, team members must be quite numerous and work in good conditions excluding stress and exhaustion. The team should always work in a quiet and well-lit environment. The operator must ensure that he has the correct equipment available (curved end guide wire) as well as an ultrasound and a radiography machine.
Emergency Medical Services Care and Sepsis Trajectories
Published in Prehospital Emergency Care, 2020
Robert Liu, Ninad S. Chaudhary, Donald M. Yealy, David T. Huang, Henry E. Wang
Time from ED arrival to trial randomization was almost 30 minutes shorter for EMS patients (P < 0.001) (Table 3). During the first 6 hours after randomization, vasopressor use and mechanical ventilation were more common in EMS patients. The intravenous fluid volume given between randomization-6 hours did not differ between EMS and non-EMS patients. In study hours 6-72, mechanical ventilation remained more common in EMS patients. EMS and non-EMS patients had similar intravenous fluid use and pressor use. Central venous catheterization was more common in EMS patients.