BookSergio Sandrucci, Baudolino Mussa, editors.
Summary: 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.
Contents:
Introduction and Overview of PICC History
Which Material and Device? The Choice of PICC
Vessel Health and Preservation: The Proactive Approach
The Choice of a Vein in Critically Ill Patients: Cost-Effectiveness
Advantages, Disadvantages, and Indications of PICCs in Inpatients and Outpatients
Ultrasound Anatomy of Peripheral Veins and Ultrasound-Guided Venipuncture
Evaluation Techniques of the PICC Tip Placement
Frequency, Diagnosis, and Management of Occlusive and Mechanical PICC Complications
Clinical Problems Associated with the Use of Peripheral Venous Approaches: Infections
Clinical Problems Associated with the Use of Peripheral Venous Approaches in Clinical Practice: Thrombosis
Maneuvers, Precautions, and Tricks for PICC Positioning Procedure
The "Off-Label" Use of PICCs
Venous Access Devices and Emotional Response in Oncologic Patients: Diagnostic and Management Aspects
Peripheral Inserted Central Catheters: Medicolegal Aspects
The PICC Team.