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Upper Limb Veins - 3D Anatomy Tutorial

Upper limb veins anatomy tutorial. Check out the 3D app at http://AnatomyLearning.com. More tutorials available on http://AnatomyZone.com. In this video tuto...  
youtube.com
over 4 years ago
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Antibiotic lock to prevent catheter infection in infants | Cochrane

Babies in the neonatal intensive care unit require medicines and fluids through their veins. To do this, a small tube (described as a central venous catheter, CVC) is inserted into the infant's vein through the umbilical cord or through the skin. This tube is placed just outside the heart. This tube is then used to give medicines and fluid without causing any discomfort. However, this tube does lead to an increased risk of infection, which can be life threatening. There are many measures taken to try to prevent this, but infection still occurs. This review looks at one way to prevent this infection by putting an antibiotic solution into the tube and leaving it to stay there for a certain length of time (called antibiotic lock) compared with a solution containing no antibiotic.  
cochrane.org
over 4 years ago
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Effectiveness of dressings and other devices that are used to keep a peripheral venous catheter in place | Cochrane

Most people admitted to an acute/emergency hospital ward require the insertion of a peripheral venous catheter/cannula (PVC), often known as a 'drip' or 'IV'. A PVC is a flexible, hollow, plastic tube that is inserted in a peripheral vein, most commonly in the hand, or lower arm. Up to half of all PVCs stop working before treatment has finished and a new one has to be inserted. This is uncomfortable for the patient and costly for the healthcare system. One of the reasons PVCs fail, is that the products used to hold them in place are not fully effective, and allow the PVC to move around. This movement causes redness, inflammation and even blood infections. The PVC can become blocked, or leak into the surrounding tissues, or even fall out as a consequence of the movement. The function of PVC dressings and/or securement devices is to keep the PVC in the vein, and to cover the insertion site so that it is kept dry and clean and protected from infection.  
cochrane.org
over 4 years ago
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Prevention of blood clots in patients undergoing cardiac or thoracic surgery | Cochrane

Patients undergoing surgery have an increased probability of developing blood clots in their veins (venous thromboembolism). These clots may be in the deep veins (deep vein thrombosis) or travel to the lungs (pulmonary embolism). As in other types of surgery, effective prevention of blood clots (thromboprophylaxis) after cardiac or thoracic surgery may reduce the risk of postoperative vein clots. These potential benefits, however, have to be balanced against the associated risks of bleeding. This systematic review looked at the effectiveness and safety of anticoagulants (medicines that reduce the ability of the blood to clot), mechanical interventions (such as pneumatic pumps on the legs to promote blood flow), and caval filters (a type of vascular filter, implanted into the main abdominal vein to prevent movement of clots from the legs to the lungs) in patients undergoing cardiac or thoracic surgery.  
cochrane.org
over 4 years ago
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Novel oral anticoagulants for the treatment of deep vein thrombosis | Cochrane

Deep vein thrombosis (DVT) is a condition in which a blood clot forms in the deep vein of the leg or pelvis. It affects approximately 1 in 1000 people. If it is not treated, the clot can travel in the blood and block the arteries in the lungs. This life-threatening condition is called a pulmonary embolism (PE) and occurs in approximately 3 to 4 per 10,000 people. The chances of getting a DVT can be increased if people have certain risk factors. These include previous clots, prolonged periods of immobility (such as travelling on aeroplanes or bed rest), cancer, exposure to oestrogens (pregnancy, oral contraceptives or hormone replacement therapy), trauma and blood disorders such as thrombophilia (abnormal blood clotting). A DVT is diagnosed through determining the risk factors and performing an ultrasound of the leg veins. If a DVT is confirmed, people are treated with an anticoagulant. This medicine prevents further clots from forming. Until recently, the drugs of choice were heparin, fondaparinux and vitamin K antagonists. However, these drugs can cause side effects and have limitations. Two further classes of novel oral anticoagulants have been developed: these are called direct thrombin inhibitors (DTI) and factor Xa inhibitors. There are particular reasons why oral DTIs and factor Xa inhibitors might now be better medicines to use. They can be given orally, they have a predictable effect, they do not require frequent monitoring or re-dosing and they have few known drug interactions. This review measures the effectiveness and safety of these new drugs with conventional treatment.  
cochrane.org
over 4 years ago
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31

CHIVA method for the treatment of varicose veins | Cochrane

Chronic venous insufficiency (CVI) is a disorder in which veins fail to pump blood back to the heart adequately. It can cause varicose veins, skin ulcers, and superficial or deep vein thrombosis in the legs. The ambulatory conservative hemodynamic correction of venous insufficiency (CHIVA) method is a minimally invasive surgical technique to treat varicose veins. The aim of the CHIVA treatment is to eliminate the venous-venous shunts by disconnecting the escape points, preserving the saphenous vein and normal venous drainage of the superficial tissues of the limb.  
cochrane.org
over 4 years ago
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Dressings and topical agents for arterial leg ulcers | Cochrane

People with blood circulation problems in their legs can develop leg ulcers. The majority of ulcers result from poor blood flow in the veins and are treated by compression. Arterial leg ulcers occur because of poor blood supply to the legs when there is a block in a leg artery or narrowing of the arteries (atherosclerosis). Without treatment of the underlying poor arterial blood supply, ulcers take a long time to heal or may never heal. These ulcers are treated by covering them with dressings, or using creams or ointments (topical agents), or both to promote healing and protect the ulcers from infection. A variety of types of dressings can be used depending on the overall aim of the treatment. The intention is to select dressings to reduce ulcer pain, manage exudate if present (the fluid that can leak from these ulcers) and promote healing.  
cochrane.org
over 4 years ago
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Electromagnetic therapy (EMT) for treating venous leg ulcers | Cochrane

Venous leg ulcers (which appear as open sores) can be caused by a blockage or breakdown in the veins of the legs. Compression of the leg, using bandages or hosiery (stockings), can help heal most of these ulcers. Electromagnetic therapy is also sometimes offered. Electromagnetic therapy is not a form of radiation or heat, but uses an electromagnetic field to try to promote healing. This review of clinical trials concluded that there is no high quality evidence about whether electromagnetic therapy speeds the healing of venous leg ulcers and its effect is unclear.  
cochrane.org
over 4 years ago
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WHAT THE HELL I AM DOING? I AM ENGORGING A VEIN IS WHAT I AM DOING!

I’m not sure where this fits in, in this age of ultrasounding everything, but there is an interesting short report in EMJ. It describes a simple technique to achieve IV access in patients where the periphery is shut down.  A typical scenario could be a patient in shock were all you can get in is a pathetic 22-24G cannula on the hand, when what you really want to do is a rapid infusion through a 14-16G in the cubital vein.  
scancrit.com
over 4 years ago
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Lidocaine for prevention of a sore throat following an operation under general anaesthetic | Cochrane

We reviewed the evidence of the effect of lidocaine for preventing a sore throat in people following an operation under general anaesthetic. (General anaesthetics are medicines used to send people asleep. They can be given via an intravenous line (IV) into the person's veins, via a mask, or via an endotracheal tube placed through the mouth past the larynx (voicebox) into the trachea. In this review the anaesthetic was given via an endotracheal tube.)  
cochrane.org
over 4 years ago
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Medical adjuvant treatment to increase the patency of arteriovenous fistulae and grafts used for renal dialysis | Cochrane

People with advanced kidney disease (end-stage renal disease) need dialysis to perform kidney functions. In haemodialysis, blood is filtered through a machine. To allow a large enough passage for blood to flow between the person and the machine, an artery and a vein can be surgically joined (to form an arteriovenous fistula) or an artificial graft (a substitute for a vein) is used to join the artery to the vein. These access points might last for years but can become blocked or infected. This review investigates if additional medical therapy can keep these dialysis access points functioning.  
cochrane.org
over 4 years ago
Sinaiem dark
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a-different-approach-to-central-line-placementu

Today’s pearl comes to you directly from Dr. Reuben Strayer (emupdates.com) and I think is particularly applicable to resident learners.  The traditional teaching for CVC placement has involved needle puncture and stabilization of said needle followed by detaching the syringe and threading a wire.  Many, typically less experienced providers (i.e. residents), have a tendency to move the needle (even while attempting to keep it stable) while removing the ultrasound or while unscrewing the syringe.  This process often dislodges the needle making it impossible to threat the wire.  A technique that has been around for some time, but is underutilized, is the wire through catheter technique, which allows you to thread a catheter over the needle so that it remains stable inside the vein, rather than having to perform the more difficult task of stabilizing the needle.  The two techniques are demonstrated in the video attached to the link that follows.  Also, do not forget your confirmatory techniques, which are discussed in the video as well.  Without further ado, the soothing voice of Dr. Strayer.  
sinaiem.org
over 4 years ago
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Comparison of propofol (an anaesthetic drug) with other drug options for sedating people undergoing painful procedures in emergency departments | Cochrane

Propofol is a drug frequently used as a general anaesthetic to sedate (calm) people for surgery in the operating theatre. It is administered into a vein. There is increasing evidence that propofol can be used outside of the operating theatre to sedate people undergoing painful procedures (e.g. when relocating a joint that is out of its normal position because of an injury) in the emergency department (ED) setting.  
cochrane.org
over 4 years ago
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The use of intravenous antibiotics to treat pulmonary exacerbations in people with cystic fibrosis | Cochrane

Do intravenous antibiotics (antibiotics given via a vein) given to treat 'flare ups' of lung disease (pulmonary exacerbations) in people with cystic fibrosis improve clinical outcomes in the short term and the long term?  
cochrane.org
over 4 years ago
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Association between pulmonary vein orientation and atrial fibrillation-free survival in patients undergoing endoscopic laser balloon ablation

Aims Obtaining optimal pulmonary vein (PV) occlusion with the endoscopic laser balloon ablation system (EAS) can be difficult, hypothetically influenced by PV geometry. The aim of this study was to determine the impact of PV orientation on atrial fibrillation (AF)-free survival after PV isolation (PVI) using the EAS.  
ehjcimaging.oxfordjournals.org
over 4 years ago
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Over time, #varicose and #spider veins... - NE Laser Vein Institute | Facebook

Over time, #varicose and #spider veins make legs feel heavy and tired, making walking a burden. Visit our website to learn more about how we can help....  
facebook.com
over 4 years ago
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Intravenous in-line filters for preventing morbidity and mortality in neonates | Cochrane

Background: Preterm or sick newborn infants are often fed with nutrients and fluids that are delivered directly into a vein. This intravenous delivery can be associated with infection, toxins released by bacteria, and tiny particles that may be in the fluids, such as rubber and plastic, going into the blood. In adults, placing a filter in the intravenous line has been reported to be effective in reducing such risks, and filters are increasingly being recommended for use in newborn infants.  
cochrane.org
over 4 years ago
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Replacing a peripheral venous catheter when clinically indicated versus routine replacement | Cochrane

Most hospital patients receive fluids or medications via an intravenous catheter at some time during their hospital stay. An intravenous catheter (also called an IV drip or intravenous cannula) is a short, hollow tube placed in the vein to allow administration of medications, fluids or nutrients directly into the bloodstream. These catheters are often replaced every three to four days to try to prevent irritation of the vein or infection of the blood. However, the procedure may cause discomfort to patients and is quite costly.  
cochrane.org
over 4 years ago
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Optical Probe Looks for Signs of Shock Without a Blood Draw |

(a) Ultrasonograph of internal jugular central vein and (b) Monte Carlo simulation of photon paths within the tissues surrounding the veins. Clinicians som  
medgadget.com
over 4 years ago