This comprehensive reference details the techniques for establishing vascular access for hemodialysis and other acute and chronic conditions that require access to the circulation along with peritoneal dialysis access methods. Includes over 960 references and more than 160 tables, figures, and photographs. Vascular Access in Clinical
This Open access book offers updated and revised information on vessel health and preservation (VHP), a model concept first published in poster form in 2008 and in JVA in 2012, which has received a great deal of attention, especially in the US, UK and Australia. The book presents a model and a new way of thinking applied to vascular access and administration of intravenous treatment, and shows how establishing and maintaining a route of access to the bloodstream is essential for patients in acute care today. Until now, little thought has been given to an intentional process to guide selection, insertion and management of vascular access devices (VADs) and by default actions are based on crisis management when a quickly selected VAD fails. The book details how VHP establishes a framework or pathway model for each step of the patient experience, intentionally guiding, improving and eliminating risk when possible. The evidence points to the fact that reducing fragmentation, establishing a pathway, and teaching the process to all stakeholders reduces complications with intravenous therapy, improves efficiency and diminishes cost. As such this book appeals to bedside nurses, physicians and other health professionals.
This practical and comprehensive book provides "how-to" information on all aspects of access to the vascular system for hemodialysis, parenteral nutrition, chemotherapy, and resuscitation. Preoperative evaluation, operations, noninvasive procedures, complications, and other aspects are detailed. This edition provides increased coverage of non-interventional techniques and includes new chapters on management of thrombophilia in hemodialysis patients; modulation of the immune system to prevent myointimal hyperplasia; synthetic grafts; venous outflow stenting for salvage of vascular access procedures; and ultrasound in vascular access procedures. This book is essential for all clinicians treating patients who require vascular access, including vascular surgeons, general surgeons, nephrologists, dialysis technicians and nurses, radiologists, and cardiologists.
Decision-making regarding the route of access to minimize procedural complications, especially in patients with unusual or complicated vascular anatomy, is extremely important for successful vascular access surgery. Several techniques for vascular access are widely disputed in the context of achieving optimal clinical outcomes. This book discusses various clinical aspects of vascular access to enrich our knowledge and understanding of the contemporary methodology and management of vascular access for a broad range of purposes. In four sections, this book examines the following topics: 1. Vascular Access: Methodology and Contemporary Management; 2. Vascular Access and Reparative Surgery; 3. Vascular Access Failure; and 4. Risk Stratification in Vascular Access.
This updated volume covers the basic principles and practice of dialysis access management. To cover the latest trends and evidence from clinical trials, new chapters on the management of cephalic arch stenosis and swing zone stenosis, the role of drug eluting balloon in dialysis access interventions, the management of central vein stenosis, endovascular creation of AVF, and the management of steal syndrome have been included. Dialysis Access Management gives readers a step-by-step guide to endovascular interventions with special emphasis on the principles and rationale behind these approaches. This book is an essential text for residents, fellows, and physicians who are learning or practicing in dialysis, especially in the fields of nephrology, radiology, surgery, and vascular medicine.
Part of the Mount Sinai Expert Guide series, this outstanding book provides rapid-access, clinical information on all aspects of Critical Care with a focus on clinical diagnosis and effective patient management. With strong focus on the very best in multidisciplinary patient care, it is the ideal point of care consultation tool for the busy physician.
Interventional Nephrology: Principles and Practice describes a very direct approach to clinical problems encountered by the community of care providers who treat chronic kidney disease and dialysis patients. Practical scenarios faced on a day-to-day basis are presented by experts in the field utilizing the latest scientific information. In addition to internal medicine residents, nephrology fellows and practitioners, this comprehensive and useful resource is a must-have for the allied health professionals taking care of patients with hemodialysis and peritoneal dialysis access problems.
The buttonhole method for the cannulation of the arteriovenous fistula was discovered more than 40 years ago and was soon adopted on a wide scale due to its obvious benefits of decreased puncture pain and extension of the life of the arteriovenous fistula. Following reports of complications such as a higher incidence of access-related infections, the method has lately been the subject of intense scrutiny; recent research has focused on the mechanisms of buttonhole access-related infections and newer techniques that may have bearing on the future use of the buttonhole method. This book presents an easily accessible overview of information relevant to the subject, including history, benefits and the latest research results related to the buttonhole cannulation method. It aims to rekindle an awareness of the advantages of this method and to encourage a critical analysis of possible techniques to overcome current barriers that prevent a wider spread of the technique.
The two-volume Emergency Medical Services: Clinical Practice and Systems Oversight delivers a thorough foundation upon which to succeed as an EMS medical director and prepare for the NAEMSP National EMS Medical Directors Course and Practicum. Focusing on EMS in the 'real world', the book offers specific management tools that will be useful in the reader's own local EMS system and provides contextual understanding of how EMS functions within the broader emergency care system at a state, local, and national level. The two volumes offer the core knowledge trainees will need to successfully complete their training and begin their career as EMS physicians, regardless of the EMS systems in use in their areas. A companion website rounds out the book's offerings with audio and video clips of EMS best practice in action. Readers will also benefit from the inclusion of: A thorough introduction to the history of EMS An exploration of EMS airway management, including procedures and challenges, as well as how to manage ventilation, oxygenation, and breathing in patients, including cases of respiratory distress Practical discussions of medical problems, including the challenges posed by the undifferentiated patient, altered mental status, cardiac arrest and dysrhythmias, seizures, stroke, and allergic reactions An examination of EMS systems, structure, and leadership
Since their first application in 1982, Totally Implantable Venous Access Devices (TIVADs) have become increasingly important in the clinical practice, as more intensive chemotherapy and parenteral treatments have come into use. At this time, there is objective evidence that TIVADs are a safe, effective strategy for long-term venous access; they play a significant role throughout the management of the oncology patient, as they are needed in the initial phases for active treatments as well as in the last stages for palliative measures, making possible repeated administration of chemotherapeutic vesicant agents, nutrients, antibiotics, analgesics, and blood products. According to a number of prospective studies, use of TIVADs is associated with a significant complication rate (10% to 25% of all patients). Evidence-based data support that most complications are directly related to inappropriate technique of placement and/or nursing care, sometimes leading to TIVAD loss, significant morbidity, increased duration of hospitalization, and additional medical cost. A group of world-renowned experts - both in the clinical and research fields – contributed to this volume, whose aim is to provide clinicians, nurses and medical students with a multidisciplinary, full update on these devices, as long term central venous access can no be longer considered a routine matter, and serious complications can be maintained at a very low level only if strict adherence to a well-defined protocol of surgical technique and of catheter care is maintained.