Main description:

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.

Contents:

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