57 results match your criteria Bedside Ultrasonography Central Line Placement


Perioperative Point-of-Care Ultrasound in Children.

Authors:
Karen Boretsky

Children (Basel) 2020 Nov 6;7(11). Epub 2020 Nov 6.

Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA.

Anesthesiologists and other acute care physicians perform and interpret portable ultrasonography-point-of-care ultrasound (POCUS)-at a child's bedside, in the perioperative period. In addition to the established procedural use for central line and nerve block placement, POCUS is being used to guide critical clinical decisions in real-time. Diagnostic point-of-care applications most relevant to the pediatric anesthesiologist include lung ultrasound for assessment of endotracheal tube size and position, pneumothorax, pleural effusion, pneumonia, and atelectasis; cardiac ultrasound for global cardiac function and hydration status, and gastric ultrasound for aspiration risk stratification. Read More

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November 2020

Diagnostic accuracy among trainees to safely confirm peripherally inserted central catheter (PICC) placement using bedside ultrasound.

Br J Nurs 2020 Oct;29(19):S20-S28

MD, University of Utah School of Medicine, Department of Medicine, Division of Pulmonary and Critical Care, Salt Lake City, UT.

Background: Real-time utilization of ultrasound to confirm peripherally inserted central catheter (PICC) placement improves efficacy and reduces patient radiation exposure. We evaluated if novice ultrasound users could accurately confirm appropriate PICC tip location via ultrasound assessment.

Methodology: A prospective data collection study was conducted in an academic center with an established PICC team. Read More

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October 2020

Role of point of care ultrasound in COVID-19 pandemic: what lies beyond the horizon?

Med Ultrason 2020 11 22;22(4):461-468. Epub 2020 Jul 22.

Department of Anesthesia and Reanimation, Hospital Universitario Mostoles, Madrid, Spain.

The pandemic of COVID-19 requires rapid and easy access to reliable imaging modalities for diagnosis and follow up. Considering the cost-effectiveness of the imaging used, ultrasound is a non-ionizing, portable and bedside imaging modality with a high diagnostic impact in emergencies and intensive care units in pandemics, but it is operator dependent. In our article, we provide a comprehensive review of the role of point-of-care ultrasound in the diagnosis of COVID-19 infection and its impact on the lungs, cardiovascular system, eyes and abdominal organs. Read More

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November 2020

Off-label use of Proglide percutaneous closure device in iatrogenic arterial catheterizations: Our experience.

Vascular 2020 Dec 21;28(6):756-759. Epub 2020 May 21.

Department of Angiology and Vascular Surgery, Hospital Álvaro Cunqueiro, Vigo, Spain.

Introduction: Incidental arterial puncture is one of the main complications associated with central venous catheter placement. Manual compression to achieve hemostasis in subclavian and carotid artery punctures is often ineffective because of the anatomical arterial position. Accidental cannulation has traditionally been treated with open surgery or endovascular treatment, but such procedures are not exempt from complications. Read More

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December 2020

Transthoracic echocardiography as bedside technique to verify tip location of central venous catheters in patients with atrial arrhythmia.

J Vasc Access 2020 Nov 4;21(6):861-867. Epub 2020 Mar 4.

Department of Anesthesia, Central Hospital of Bolzano, Bolzano, Italy.

Introduction: Transthoracic echocardiography with bubble test is an accurate, reproducible, and safe technique to verify the location of the tip of the central venous catheter. The aim of this study is to confirm the effectiveness of this method for tip location in patients with atrial arrhythmia.

Methods: Transthoracic echocardiography with bubble test was adopted as a method of tip location in patients with atrial arrhythmia requiring central venous catheter. Read More

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November 2020

Point-of-Care Ultrasonography.

Am Fam Physician 2020 03;101(5):275-285

Naval Hospital Jacksonville, Jacksonville, FL, USA.

Point-of-care ultrasonography (POCUS) is performed by a physician at the bedside and is standard practice in obstetric, emergency, and musculoskeletal medicine. When compared with formal sonography, POCUS is equivalent in screening for abdominal aortic aneurysm and as accurate in diagnosing deep venous thrombosis. POCUS has high accuracy for diagnosing pneumonia and detecting acute decompensated heart failure but is less accurate than computed tomography for identifying pulmonary embolism. Read More

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From the simulation center to the bedside: Validating the efficacy of a dynamic haptic robotic trainer in internal jugular central venous catheter placement.

Am J Surg 2020 02 21;219(2):379-384. Epub 2019 Oct 21.

Department of Industrial and Manufacturing Engineering, Pennsylvania State University, University Park, PA, 16802, USA; Department of Surgery, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, 17033, USA; School of Engineering Design, Technology, and Professional Programs, Pennsylvania State University, University Park, PA, 16802, USA. Electronic address:

Background: The objective of this study was to validate the transfer of ultrasound-guided Internal Jugular Central Venous Catheterization (US-IJCVC) placement skills from training on a Dynamic Haptic Robotic Trainer (DHRT), to placing US-IJCVCs in clinical environments. DHRT training greatly reduces preceptor time by providing automated feedback, standardizes learning experiences, and quantifies skill improvements.

Methods: Expert observers evaluated DHRT-trained (N = 21) and manikin-trained (N = 36) surgical residents on US-IJCVC placement in the operating suite using a US-IJCVC evaluation form. Read More

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February 2020

Safety and feasibility of ultrasound-guided placement of peripherally inserted central catheter performed by neurointensivist in neurosurgery intensive care unit.

PLoS One 2019 31;14(5):e0217641. Epub 2019 May 31.

Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

We evaluated the safety and feasibility of ultrasound-guided peripherally-inserted central venous catheters (PICC) by a neurointensivist at the bedside compared to fluoroscopy-guided PICC and conventional central venous catheter (CCVC). This was a retrospective study of adult patients who underwent central line placement and were admitted to the neurosurgical intensive care unit (ICU) between January 2014 and March 2018. In this study, the primary endpoint was central line-induced complications. Read More

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January 2020

Development and Implementation of a Bedside Peripherally Inserted Central Catheter Service in a PICU.

Pediatr Crit Care Med 2019 01;20(1):71-78

Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA.

Objectives: To create a bedside peripherally inserted central catheter service to increase placement of bedside peripherally inserted central catheter in PICU patients.

Design: Two-phase observational, pre-post design.

Setting: Single-center quaternary noncardiac PICU. Read More

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January 2019

Use of Bedside Ultrasonography and Saline Flush Technique for Evaluation of Central Venous Catheter Placement in Children.

Artif Organs 2018 Dec 22;42(12):1157-1163. Epub 2018 Aug 22.

Department of Pediatric Radiology, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey.

Our study investigated the reliability of appearance of rapid atrial swirl flow (RASF) by ultrasonography (US) in the right atrium (RA), which occurred as a result of rapid isotonic saline infusion (RISI) into the central venous catheter (CVC), in predicting catheter tip position. This prospective observational study included 95 CVC procedures performed on 77 pediatric patients (41 boys and 36 girls) with a median age of 0.6 (0. Read More

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December 2018

Real-time ultrasound-guided placement of peripherally inserted central venous catheter without fluoroscopy.

J Vasc Access 2018 Nov 21;19(6):609-614. Epub 2018 Mar 21.

2 Division of Cardiology, JCHO Tokyo Takanawa Hospital, Tokyo, Japan.

Background And Aim:: Malposition of peripherally inserted central catheters placed at the bedside is a well-recognized phenomenon. We report the success rate of the placement of peripherally inserted central catheters with ultrasound guidance for tip positioning and describe the knacks and pitfalls.

Materials And Methods:: We retrospectively reviewed the medical case charts of 954 patients who received peripherally inserted central catheter procedure. Read More

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November 2018

Bedside ultrasound to detect central venous catheter misplacement and associated iatrogenic complications: a systematic review and meta-analysis.

Crit Care 2018 Mar 13;22(1):65. Epub 2018 Mar 13.

Department of Intensive Care Medicine, Research VUmc Intensive Care (REVIVE), VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.

Background: Insertion of a central venous catheter (CVC) is common practice in critical care medicine. Complications arising from CVC placement are mostly due to a pneumothorax or malposition. Correct position is currently confirmed by chest x-ray, while ultrasonography might be a more suitable option. Read More

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Ultrasound-guided central venous catheter placement in children: what is a really good practice?

Intensive Care Med 2018 04 6;44(4):546-547. Epub 2018 Mar 6.

Paediatric and Emergency Care Department, Complejo Hospitalario Universitario de Santiago de Compostela, Travesía de Choupana, s/n, 15706, Santiago De Compostela, Spain.

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Semi-automated ultrasound guidance applied to nasogastrojejunal tube replacement for enteral nutrition in critically ill adults.

Biomed Eng Online 2018 Feb 7;17(1):21. Epub 2018 Feb 7.

Department of Critical Care Medicine, Second People's Hospital of Shenzhen, Shenzhen, 518035, People's Republic of China.

Background And Objective: At present, the enteral nutrition approaches via nose and duodenum (or nose and jejunum) are the preferred method of nutritional support in the medical engineering field, given the superiority of in line with physiological processes and no serious complication. In this study, the authors adopted saline as the acoustic window, and gave enteral nutrition support to critically ill patients, via the nasogastrojejunal approach guided by semi-automated ultrasound. These above patients benefited a lot from this kind of nutrition support treatment, and we aimed to report the detailed information. Read More

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February 2018

Incidental finding of persistent left superior vena cava after 'bubble study' verification of central venous catheter.

BMJ Case Rep 2017 Jul 31;2017. Epub 2017 Jul 31.

Department of Medicine, Jackson Memorial Hospital, Miami, Florida, USA.

We report a case of a patient with septic shock who underwent central venous catheter placement in the left internal jugular vein, and a bedside ultrasound 'bubble study' revealed venous cannulation. A chest X-ray postprocedure revealed concern for arterial system catheterisation. However, the possibility of a persistent left superior vena cava was discussed and confirmed with a formal transthoracic echocardiogram and CT. Read More

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Simulation-based training program with deliberate practice for ultrasound-guided jugular central venous catheter placement.

Acta Anaesthesiol Scand 2017 Oct 6;61(9):1184-1191. Epub 2017 Jul 6.

Department of Anesthesiology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.

Background: Current evidence supports the utility of simulation training for bedside procedures such as ultrasound-guided jugular central venous catheter (CVC) insertion. However, a standardized methodology to teach procedural skills has not been determined yet. The aim of this study was to evaluate the effectiveness of a simulation-based training program for improving novice technical performance during ultrasound-guided internal jugular CVC placement. Read More

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October 2017

Report of Modification for Peripherally Inserted Central Catheter Placement: Subcutaneous Needle Tunnel for High Upper Arm Placement.

J Infus Nurs 2017 Jul/Aug;40(4):232-237

Vascular Access Department, St Joseph's Regional Medical Center, Paterson, New Jersey (Mr Ostroff); PICC Excellence, Inc, Hartwell, Georgia (Ms Moureau); Greenville Memorial University Medical Center, Greenville, South Carolina (Ms Moureau); Griffith University, School of Nursing and Midwifery, Brisbane, Australia (Ms Moureau); and Alliance for Vascular Access Teaching and Research, Brisbane, Australia (Ms Moureau). Matthew D. Ostroff, MSN, RN, AGACNP, CRNI®, CPUI, VA-BC, CEN, recently completed an acute care adult and geriatric nurse practitioner certification and a master's degree from Drexel University. He is currently an advanced practice nurse at St. Joseph's Regional Medical Center, Paterson, New Jersey, where he performs ultrasound-guided peripheral and central vascular access device placement. Nancy L. Moureau, BSN, RN, CRNI®, CPUI, VA-BC, is a researcher in conjunction with Griffith University, where she is pursuing a doctorate in nursing research. She is also a vascular access staff nurse with Greenville Memorial University Medical Center, where she places ultrasound-guided peripheral and peripherally inserted central catheters. The owner of PICC Excellence, Inc, Ms Moureau also is an educator, consultant, and legal expert on vascular access.

The majority of peripherally inserted central catheters (PICCs) are currently inserted with the aid of ultrasound guidance in the middle third of the upper arm. A growing patient population is presenting with challenging vessel access requiring placement of the PICC in the high upper third of the arm. To avoid this suboptimal exit site, a subcutaneous tunneling of the PICC is established away from the axilla to a more appropriate skin exit site. Read More

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September 2017

A Missing Guide Wire After Placement of Peripherally Inserted Central Venous Catheter.

Am J Case Rep 2016 Dec 6;17:925-928. Epub 2016 Dec 6.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Bronx Lebanon Hospital Center Affiliated with Icahn School of Medicine at Mount Sinai, Bronx, NY, USA.

BACKGROUND Central venous catheterization is a common tool used in critically ill patients to monitor central venous pressure and administer fluids and medications such as vasopressors. Here we present a case of a missing guide wire after placement of peripherally inserted central catheter (PICC), which was incidentally picked up by bedside ultrasound in the intensive care unit.  CASE REPORT A 50-year-old Hispanic male was admitted to the intensive care unit for alcohol intoxication. Read More

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December 2016

Two successful insertions of peripherally inserted central catheter in a super elderly patient with bilateral pacemaker placement.

J Vasc Access 2017 Jan 18;18(1):e1-e2. Epub 2017 Jan 18.

Department of Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing - China.

Peripherally inserted central catheters (PICCs) have been placed through the peripheral veins, and the best location for the tip of the PICCs is the lower third of the superior vena cava (SVC) and cavo-atrial junction. PICCs are commonly used in intravenous administration, parenteral nutrition therapy, chemotherapy, as well as in critical care units. The success rates in venipuncture are enhanced when ultrasonographic guides are used by the bedside PICC teams. Read More

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January 2017

12th WINFOCUS world congress on ultrasound in emergency and critical care.

Crit Ultrasound J 2016 Sep;8(Suppl 1):12

Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.

Table Of Contents: A1 Point-of-care ultrasound examination of cervical spine in emergency departmentYahya Acar, Onur Tezel, Necati SalmanA2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasoundYahya Acar, Necati Salman, Onur Tezel, Erdem CevikA3 Pseudoaneurysm of the femoral artery after cannulation of a central venous line. Should we always use ultrasound in these procedures?Margarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA4 Ultrasound-guided supraclavicular subclavian vein catheterization. A novel approach in emergency departmentMargarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA5 Clinical ultrasound in a septic and jaundice patient in the emergency departmentMargarita Algaba-Montes, Alberto Oviedo-García, Mayra Patricio-BordomásA6 Characterization of the eyes in preoperative cataract Saudi patients by using medical diagnostic ultrasoundMustafa Z. Read More

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September 2016

The Barriers and Facilitators to Transfer of Ultrasound-Guided Central Venous Line Skills From Simulation to Practice: Exploring Perceptions of Learners and Supervisors.

Teach Learn Med 2016 ;28(2):115-24

b Department of Medical Education , University of Illinois at Chicago , Chicago , Illinois , USA.

Unlabelled: PHENOMENON: Ultrasound-guided central venous line insertion is currently the standard of care. Randomized controlled trials and systematic reviews show that simulation is superior to apprenticeship training. The purpose of this study is to explore, from the perspectives of participants in a simulation-training program, the factors that help or hinder the transfer of skills from simulation to practice. Read More

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January 2017

Ultrasonography for Central Catheter Placement in the Neonatal Intensive Care Unit-A Review of Utility and Practicality.

Authors:
Jimmy Nguyen

Am J Perinatol 2016 05 21;33(6):525-30. Epub 2015 Dec 21.

Division of Neonatology and the Center for Fetal and Neonatal Medicine, Department of Pediatrics, Children's Hospital Los Angeles and the LAC+USC Medical Center, Keck School of Medicine, University of Southern California, Los Angeles, California.

Objective Central catheters (CCs) are routinely used in the neonatal intensive care unit (NICU). Ultrasonography (US) has been advocated as a procedural adjunct for CC placement to better localize catheter tip position (CTP), minimize radiation exposure, and decrease procedural burden. This review evaluates the clinical benefit, practical considerations for implementation, and limitations of US for CC placement in the NICU. Read More

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Lower Extremity Vascular Access in Neonates and Infants: A Single Institutional Experience.

J Vasc Interv Radiol 2015 Nov;26(11):1660-8

Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104.

Purpose: To demonstrate feasibility and evaluate outcomes of direct-stick saphenous and single-incision tunneled femoral noncuffed central venous catheters (CVCs) placed in a large series of neonates and infants at a single institution.

Materials And Methods: A retrospective review was performed for all neonates and infants receiving a lower extremity CVC by interventional radiology between 2007 and 2012. Technical success, mechanical and infectious complications, and catheter outcomes were recorded. Read More

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November 2015

Ultrasound-guided procedures in medical education: a fresh look at cadavers.

Intern Emerg Med 2016 Apr 15;11(3):431-6. Epub 2015 Aug 15.

Department of Emergency Medicine, University of Arizona Medical Center, PO Box 245057, Tucson, AZ, 85724-5057, USA.

Demand for bedside ultrasound in medicine has created a need for earlier exposure to ultrasound education during the clinical years of undergraduate medical education. Although bedside ultrasound is often used for invasive medical procedures, there is no standardized educational model for procedural skills that can provide the learner a real-life simulated experience. The objective of our study was to describe a unique fresh cadaver preparation model, and to determine the impact of a procedure-focused ultrasound training session. Read More

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Saline Flush Test: Can Bedside Sonography Replace Conventional Radiography for Confirmation of Above-the-Diaphragm Central Venous Catheter Placement?

J Ultrasound Med 2015 Jul;34(7):1295-9

Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York USA (R.G., S.H., R.B., T.C., G.P., J.D., T.L.S., C.R., V.M., M.N.); St John's Riverside Hospital, Yonkers, New York USA (L.D.); and Long Island Jewish Medical Center, New Hyde Park, New York USA (A.C.).

Objectives: Resuscitation often requires rapid vascular access via central venous catheters. Chest radiography is the reference standard to confirm central venous catheter placement and exclude complications. However, radiographs are often untimely. Read More

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Fluoroscopy-guided Umbilical Venous Catheter Placement in Infants with Congenital Heart Disease.

Congenit Heart Dis 2015 Jul-Aug;10(4):317-25. Epub 2014 Nov 17.

Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, University of Michigan, Ann Arbor, Mich, USA.

Objective: The objective of this study was to (1) describe the technical aspects of fluoroscopy-guided umbilical venous catheter placement (FGUVCP); and (2) determine the procedural success rate, factors contributing to procedural failure, and risks of the procedure.

Background: Umbilical venous catheters are advantageous compared with femoral venous access, but can be difficult to place at the bedside.

Materials And Methods: This was a retrospective chart review from a single tertiary care referral institution. Read More

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Ultrasound-guided central venous access using Google Glass.

J Emerg Med 2014 Dec 1;47(6):668-75. Epub 2014 Oct 1.

University of Arizona College of Medicine-Phoenix, Phoenix, Arizona; Phoenix Children's Hospital, Phoenix, Arizona.

Background: The use of ultrasound during invasive bedside procedures is quickly becoming the standard of care. Ultrasound machine placement during procedures often requires the practitioner to turn their head during the procedure to view the screen. Such turning has been implicated in unintentional hand movements in novices. Read More

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December 2014

A single institution experience of seven hundred consecutively placed peripherally inserted central venous catheters.

J Vasc Access 2014 Nov-Dec;15(6):498-502. Epub 2014 May 9.

1 Department of Surgery, Bronx-Lebanon Hospital Center, Bronx, NY - USA.

Introduction: Peripherally inserted central venous catheters (PICCs) are being increasingly placed at the bedside by trained vascular access professional such as nurses. This is to increase the availability of the service, for cost containment, and to reduce the workload on the interventional radiologist. We describe a single institution experience with over 700 PICC lines placed by trained nurses at the bedside and determine the success rate, malposition rate of the PICC line , degree of support needed from the Interventional radiologist, and factors affecting a successful placement of a PICC line by the nurses. Read More

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US-guided placement and tip position confirmation for lower-extremity central venous access in neonates and infants with comparison versus conventional insertion.

J Vasc Interv Radiol 2014 Apr;25(4):548-55

Department of Radiology, Children's Hospital of Philadelphia, Perelman School of Medicine of the University of Pennsylvania, 3401 Civic Center Blvd., Philadelphia, PA 19104.

Purpose: To describe experience with the use of ultrasound (US)-guided placement and tip position confirmation for direct saphenous and single-incision tunneled femoral noncuffed central venous catheters (CVCs) placed in neonates and infants at the bedside.

Materials And Methods: A retrospective review of the interventional radiology (IR) database and electronic medical records was performed for 68 neonates and infants who received a CVC at the bedside and for 70 age- and weight-matched patients with CVCs placed in the IR suite between 2007 and 2012. Technical success, complications, and outcomes of CVCs placed at the bedside were compared with those in an age- and weight-matched sample of children with CVCs placed in the IR suite. Read More

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Central vascular catheter placement evaluation using saline flush and bedside echocardiography.

Acad Emerg Med 2014 Jan;21(1):65-72

The Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC.

Objectives: Central venous catheter (CVC) placement is a common procedure in critical care management. The authors set out to determine echocardiographic features during a saline flush of any type of CVC. The hypothesis was that the presence of a rapid saline swirl in the right atrium on bedside echocardiography would confirm correct placement of the CVC tip, similar to the accuracy of the postplacement chest radiograph (CXR). Read More

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January 2014