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Provides detailed guidance and tips on the use of ultrasound and other non-invasive techniques for peripheral insertion of central catheters
Offers advice on choice of materials and the prevention, diagnosis, and management of complications
Includes special chapters on psychological, legal, and economic issues
Indications for central venous cannulation in critically ill patients have increased dramatically in recent years owing to the use of more complex therapies unsuitable for delivery via peripheral veins. The main drawbacks of central venous access are morbidity and the growing 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 the choice of materials and on vein selection. The advantages and disadvantages of peripherally inserted central venous catheters (PICC) in relation to other types of central venous catheter are discussed, and the principles of use and practical applications of ultrasound for venipuncture are explained. Maneuvers for PICC positioning, techniques for the evaluation of PICC tip placement, and the prevention, diagnosis, and management of complications are all described in detail. Advice is also provided on the organization of a dedicated PICC team within a hospital or a supportive care program, and psychological, legal, and economic issues are considered.
Peripherally Inserted Central Venous Catheters will be of interest to a wide range of professionals, including nutritionists, oncologists, anesthesiologists, surgeons, registered nurses, nurse practitioners, physicians, physician assistants, and radiologists.
Preface.- 1 Introduction and Overview of PICC History.- 2 Which Material and Device? The Choice of PICC.- 3 The Concept of Vessel Health and Preservation: the Proactive Procedure.- 4 The Choice of a Vein in Critically Ill patients: Cost-Effectiveness.- 5 Advantages, Disadvantages and Indications of PICC in Inpatients and Outpatients.- 6 Ultrasound Anatomy of Peripheral Veins and Ultrasound Guided Venipuncture.- 7 Evaluation Techniques of the PICC Tip Placement.- 8 Frequency, Diagnosis and Management of Occlusive and Mechanical PICC Complications.- 9 Clinical Problems Associated to the use of Peripheral Venous Approaches in Clinical Practice: Infections.- 10 Clinical Problems Associated with the use of Peripheral Venous Approaches in Clinical Practice: Thrombosis.- 11 Maneuvers, precautions and tricks for PICC Positioning Procedure.- 12 The “Off Label” Use of PICC Catheters.- 13 Ethical and Psychological Aspects of Peripherally Inserted Central Catheters.- 14 Legal Aspects of Peripherally Inserted Central Catheters.- 15 The PICC Team.- Subject Index