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Becton, Dickinson And — Conference Presentation (January 2020)
35 slides from Becton, Dickinson And's conference presentation, Jan 16, 2020
Slide 1: Presenter views disclaimer
These presentations were developed by the respective presenter(s), and the findings, interpretations, and conclusions contained or expressed with them do not necessarily reflect the views of BD. To the extent these presentations relate to specific products, such products should always be used in acc
Slide 2: Alternative devices for DIVA patients and operating theatres
Alternative devices for DIVA patients and operating theatres Milica Matic M.D. Department of Anesthesiology and Perioperative Medicine Acute and Chronic Pain Therapy - UZ Brussel 16 january 2020 Edinburgh Edinburg
Slide 3: Universitair Ziekenhuis Brussel
Universitair Ziekenhuis Brussel ⚫ University Hospital Brussels ⚫ 721 beds ⚫ 30 000 hospitalisations / year ⚫ 15 000 surgery / year
Slide 4: Universitair Ziekenhuis Brussel intravenous therapy team
Universitair Ziekenhuis Brussel ⚫ Intravenous therapy team • Anesthesiology department • Specialized nurses catheter team • Radiology department • Hospital hygiene and microbiology service • Pharmacy • Oncology and paliative care departmenet • Surgery department • Intensive care department • Emergen
Slide 5: Alternative devices for DIVA patients and operating theatres
Alternative devices for DIVA patients and operating theatres ⚫ 1st step of decision making : What kind of intravenous acces is indicated per- and postoperatively following the guidelines ⚫ 2nd step of decision making; is to identify the DIVA patients and to join the 1st and the 2nd decision making i
Slide 6: Vascular Access Device Decision Tree
Vascular Access Device Decision Tree
Slide 7: A clinical pathway for the management of difficult venous access
A clinical pathway for the management of difficult venous access Conclusion The use of ultrasound guidance for peripheral intravenous catheter insertion by the after-hours clinical support team for patients with difficult venous access has been successful at our institution with 9 out of every 10 ca
Slide 8: A clinical pathway for the management of difficult venous access
A clinical pathway for the management of difficult venous access December 2017 – BMC Nursing 16
Slide 9: The Modified A-DIVA Scale as a Predictive Tool
Alternative devices for DIVA patients and operating theatres The Modified A-DIVA Scale as a Predictive Tool ⚫ 3587 participants ⚫ The first attempt success rate was 81% ⚫ Five variables were included in the prediction model: • a history of difficult intravenous cannulation, • a difficult intravenous
Slide 10: The Modified A-DIVA Scale: validation study results
The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study ⚫ The 1st attempt success rate of the total cohort was 81% (2923 participants) ⚫ 2 attempts were needed in 425 participants (12%),
Slide 11: The Modified A-DIVA Scale as a Predictive Tool
The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study
Slide 12: Alternative devices for DIVA patients and operating theatres
Alternative devices for DIVA patients and operating theatres ⚫ Catheter type ⚫ Choice of device ⚫ Risk assessment
Slide 13: Mini-midline in difficult intravenous access patients in emergency department
Mini-midline in difficult intravenous access patients in emergency department: A prospective analysis A total of 46 patients out of 50 were monitored. In 38 (82%) patients, the device was removed due to the end of the indication, and in six of them, it was replaced by a central venous catheter. Conc
Slide 14: Mini-Midline a New Device for Peripheral Venous Catheterization
Mini-Midline a New Device for Peripheral Venous Catheterization UN Emergency Wards Discussion: It has been proved that a mini-midline can be rather effective in emergency wards as well. With its swiftness and highly effective placement, mini-midline turns out to be very useful for those patients tha
Slide 15: The Midline Catheter: A Clinical Review
The Midline Catheter: A Clinical Review Objective To compare venous access device indications and complications, highlighting the use of midline catheters as a potentially cost-effective and safe approach for venous access in the ED. Conclusion The MC is a versatile venous access device with a low c
Slide 16: Recommendations on Ultrasound Guidance for Vascular Access
Recommendations on the Use of Ultrasound Guidance for Central and Peripheral Vascular Access in Adults: A Position Statement of the Society of Hospital Medicine Peripheral Venous Access Techniques 15) We recommend that providers should use real-time ultrasound guidance for the insertion of periphera
Slide 17: Ultrasound-guided deep-arm veins insertion of long peripheral catheters
Ultrasound-guided deep-arm veins insertion of long peripheral catheters in patients with difficult venous access after cardiac surgery Objectives To analyze success rate, dwell-time, and complications of long peripheral venous catheters (L-PVCs) inserted under ultrasound guidance. Conclusion L-PVC c
Slide 18: Efficacy of Ultrasound-Guided Peripheral Intravenous Access
Efficacy of Ultrasound-Guided Peripheral Intravenous Access: A Systematic Review and Meta-Analysis BACKGROUND: Peripheral intravenous access is a common, invasive procedure that is performed in clinical practice. Difficult intravenous access may not only jeopardize patient safety but also increase s
Slide 19: Ultrasound guidance for difficult peripheral venous access
Ultrasound guidance for difficult peripheral venous access: systematic review and meta-analysis OBJECTIVES: This systematic review and meta-analysis aimed to determine the clinical effectiveness of Ultrasound-guided peripheral intravenous cannulation compared with the standard technique in patients
Slide 20: Development of a nurse-led ultrasound-guided peripheral intravenous program
Development of a nurse-led ultrasound- guided peripheral intravenous program Conclussion: Point-of-care US to insert PIVs in patients with DVA is becoming commonplace in the health-care arena. For minimal cost, compared with one single CLABSI, a nurse-led USGPVA can be established. RNs can be effect
Slide 21: Veinplicity versus heat treatment for vein dilation
Veinplicity versus heat treatment for vein dilation: A randomised cross-over study BACKGROUND: Patients with difficult venous access require special measures to facilitate cannulation. Veinplicity applies mild electrical stimulation to forearm veins to aid vessel dilation. CONCLUSION: Veinplicity di
Slide 22: Use of intra-osseous access in adults: a systematic review
Use of intra-osseous access in adults: a systematic review Background Indications for intra-osseous (IO) infusion are increasing in adults requiring administration of fluids and medications during initial resuscitation. However, this route is rarely used nowadays due to a lack of knowlegde and train
Slide 23: Risk factors for a difficult intravenous access
Risk factors for a difficult intravenous access: A multicentre study comparing nurses' beliefs to evidence BACKGROUND: Peripheral intravenous cannulation is a common procedure for nurses, but rates of failure at first attempt of peripheral intravenous cannulation range 10%-40%. Nurses' beliefs about
Slide 24: Ultrasound-guided techniques in children with difficult venous access
Ultrasound‐guided techniques for peripheral intravenous placement in children with difficult venous access Recommendations: ⚫ Ultrasound for vein localization (Short axis ‐ out of plane) ⚫ Catheter over needle ⚫ Catheter over wire Ultrasound‐guided techniques for peripheral intravenous placement in
Slide 25: Ultrasound-guided techniques in children: key learning points
Ultrasound‐guided techniques for peripheral intravenous placement in children with difficult venous access 4 KEY LEARNING POINTS ⚫ The utility of ultrasound guidance for peripheral intravenous placement in awake children with difficult access has shown inconsistent results and minor clinical benefit
Slide 26: Reflective questions
Ultrasound‐guided techniques for peripheral intravenous placement in children with difficult venous access REFLECTIVE QUESTIONS ⚫ What percentage of the patients you provide anesthesia for have a history of DiVA? ⚫ What alternative techniques do you use to place a PIV when a landmark technique has f
Slide 27: Near-Infrared Light Device in Pediatric Intravenous Cannulation
Near-Infrared Light Device in Pediatric Intravenous Cannulation: A Randomized Controlled Trial ⚫ Use of a near-infrared light device did not show a benefit in first-attempt success rate in IV placement among pediatric patients in a large children's hospital ED ⚫ Use of the device was associated with
Slide 28: First-attempt success of intravenous cannulation in older people
Factors affecting the first‐attempt success rate of intravenous cannulation in older people Background In older patients who require Intravenous treatment, establishing a PIVC as fast as possible is clinically important. Conclusion Factors affecting first‐attempt success rates in peripheral intraven
Slide 29: Vessel Health and Preservation Device Selection
Vessel Health and Preservation Device Selection Reducing risk and unnecessary harm in the hospital environment begins with assessment of the patient’s condition, history, risk assessment and relative vessel health. Matching the patient’s current state of health with the need for intravenous access p
Slide 30: Vessel Health and Preservation: Device Selection
Vessel Health and Preservation: The Right Approach for Hick cates ~ Device Selection Medication / infusate Estimated characteristics duration Care setting/population > qualification of inserters/providers > appropriate device selection Indications for VAD Device and treatment risk factors Patient Pa
Slide 31: Patient risk assessment
Patient risk assessment Patient MRN: Age: Admission Date: Discharge Date: LOS: Diagnosis List: 1. 2. 3. Infusions: 1. 2. 3. 4. 5. « Daily assessment of device need documented for each day? Yes/No « Documentation of device choice based on assessment of patient need and risk factors? Yes/No « Document
Slide 32: University hospital Brussels 2019
University hospital Brussels ⚫ 2019 DIVA Midline PICC line Peripheral IVA MiniMidline 720 124 350
Slide 33: University hospital Brussels DIVA peripheral IVA
University hospital Brussels DIVA Peripheral IVA ⚫ 1st line dedicated nurse team (operating theatre) ⚫ 2nd line anethesist (operating theatre) ⚫ Minimidline, Midline and PICC IVA anesthesist ( operating theatre)
Slide 34: University hospital Brussels
University hospital Brussels ⚫ Separate space in the operating theatre ⚫ Nurse team for IVA 07-18 ⚫ Postoperative Care nurse team 18–07 ⚫ Ultrasound procedures
Slide 35: Thank you !
Thank you !
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