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2 results

  • 5.2.3 - Central Venous Catheterisation

  • from Section 5.2 - Practical Cardiovascular System
  • Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
  • Book:
    Intensive Care Medicine
    Published online:
    27 July 2023
    Print publication:
    01 December 2021, pp 567-570

  • Summary

    Key Learning Points

    1. 1. Ultrasound guidance is the gold standard of care for central line insertion.

    2. 2. The number of unsuccessful attempts at cannulation is directly proportional to the likelihood of subsequent complications.

    3. 3. Factors such as current clinical condition, body habitus, co-morbidities and intended duration of catheterisation should influence the choice of puncture site.

    4. 4. The length of guidewire and catheter used is determined by the side and site of insertion.

    5. 5. The puncture site should be regularly assessed for signs of infection – line-associated sepsis is a significant cause of morbidity in the critical care setting.

  • 5.1.6 - Chest Drain Insertion

  • from Section 5.1 - Practical Respiratory System
  • Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
  • Book:
    Intensive Care Medicine
    Published online:
    27 July 2023
    Print publication:
    01 December 2021, pp 544-548

  • Summary

    Key Learning Points

    1. 1. Clear British Thoracic Society guidelines exist for optimal management of a pneumothorax.

    2. 2. Different techniques exist for chest drain insertion, each with its own advantages and disadvantages.

    3. 3. Chest drains must be secured adequately, otherwise they will fall out.

    4. 4. Be careful to avoid re-expansion pulmonary oedema.

    5. 5. Always send samples if a fluid is drained.