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Becton, Dickinson And — Technical Presentation (April 2020)
7 slides from Becton, Dickinson And's technical presentation, April 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: Managing the complex patient – a case study
Managing the complex patient – a case study Dr Tim Jackson Consultant Anaesthetist Calderdale & Huddersfield NHS Foundation Trust
Slide 3: Case study – MK, 44year old male
Case study – MK, 44year old male • Recovering IV drug user • Repeated medical admissions • Hypocalcaemia • Anaemia • Multiple clinical teams involved • Challenging individual! • Now attending at least once a week for blood tests & IV drugs • Repeated ad-hoc acute CVADs In past, increasingly difficul
Slide 4: What would you do?
What would you do? • Get somebody else to deal with him • Avoid IV access at all (too risky) • Advise PICC • Advise Tunnelled CVC • Advise Port • Advise another type of VAD • Something else
Slide 5: In my institution.....
In my institution..... • A colleague had already decided to insert a tunnelled CVC • Recurrent CRBSIs • Several ‘knee jerk’ removals before consideration of line salvage • Successful salvage • Indwelling tunnelled line • Patient improved, now no longer receiving IV therapy • Refusing to attend hospi
Slide 6: What would you do?
What would you do? • Patient has capacity, let him refuse all he wants • Force him to come into hospital & insist on line removal • He’s at risk of further episodes of acute illness, leave it in place
Slide 7: My thoughts about such complex patients
My thoughts about such complex patients • Increasingly common challenge • Often chronically unwell medical patients • Poorly understood group of ‘conditions’ • Physicians don’t understand VA risks • VHP approach should lessen the challenge • Multidisciplinary approach- VA involvement vital • Higher
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