Central Line Placement: The Seldinger Technique

The most nerve-racking step of central line placement for the inexperienced practitioner is accessing the vein. My preferred way to safely access the vein for central line placement is to use the Modified Seldinger Technique. In some studies for ultrasound-guided internal jugular vein catheterization, the modified Seldinger techniqueshowed superiority over the Seldinger technique in terms… Continue reading Central Line Placement: The Seldinger Technique

Comparing French Sizing to Gauge for IVs and Central Venous Catheters

By convention, peripheral IV catheters are sized in gauge, and central venous catheters (CVCs) are sized in French. This table compares French sizing to gauges for catheters with flow rates. Comparing French Sizing to Gauges with flow rates Poiseuille’s Law for IV Flow Rates Catheter sizes are critical if you are trying to rapidly transfuse… Continue reading Comparing French Sizing to Gauge for IVs and Central Venous Catheters

Massive Transfusion Protocol (MTP) Best Practices

The exsanguinating patient, it’s a problem we don’t want to experience and can be found all over healthcare. It can be the ED trauma patient, the OB with a placenta accrete, an open aortic aneurysms repair or even your GI bleed patient in the ICU. Most of these situations are best handled with massive transfusion… Continue reading Massive Transfusion Protocol (MTP) Best Practices

3 Ways to Eliminate the Newsletters, Keep the Content

Have you gone into your email to find an old message to complete a critical task only to find yourself an hour later reading some of a well-written, interesting article but your task remains incomplete.If so you are not alone, our current systems of information management are not designed to minimized distractions. What you need… Continue reading 3 Ways to Eliminate the Newsletters, Keep the Content

Healthcare Analytics for Quality and Performance Improvement

Depending on your role in your healthcare organization, you likely have a different comfort level with analytics. As a clinician who is growing as a patient safety professional, I needed to get a better grasp on healthcare analytics and how I can use analytics for Quality and Performance Improvement. Best Books for Healthcare Analytics A… Continue reading Healthcare Analytics for Quality and Performance Improvement

Ultrasound-Guided Subclavian Central Line Placements

The central line insertion location has an outsized impact on a number of quality metrics related to central line safety. Sadly, the 20 y/o intern there to place the line, often late in the afternoon, rarely can connect their choice of location to the care and maintenance of that line by the nursing staff and… Continue reading Ultrasound-Guided Subclavian Central Line Placements

What is Rapid Central Vein Assessment (RaCeVA)?

Rapid Central Vein Assessment (RaCeVA) is a systematic, standardized approach for ultrasound assessment before central venous catheterization.  Ultrasound use for central line placement not only provides superior procedural advantages but can also be used to perform a thorough assessment of the vascular structures to evaluate vessel health, viability, size, and patency, including the location of… Continue reading What is Rapid Central Vein Assessment (RaCeVA)?

Should You Double-Stick Your Central Lines?

I wasn’t very familiar with the term “double-stick” when I went through my anesthesia residency. Although we did the typical “big cases” and trauma, we did not routinely place two central lines in a single vein of the same patient. In my current practice, however, it is very common to place two central venous catheters… Continue reading Should You Double-Stick Your Central Lines?