What is vascular access? Definitions, clinical context, the full VAD spectrum from peripheral to central, indications for each device type, and who performs vascular access procedures.
Complete guide to vesicant administration safety: vesicant and irritant classification, mandatory central access requirements, peripheral vesicant administration protocols, pre-infusion assessment, monitoring requirements, and immediate response to suspected extravasation.
Clinical guide to vascular anatomy for ultrasound-guided vascular access: upper extremity veins (basilic, brachial, cephalic), internal jugular vein, femoral vessels — identification, landmarks, and differentiating vein from artery on ultrasound.
The definitive clinical reference on vascular access — device spectrum, evidence-based selection, INS standards, complication overview, documentation, and quality metrics for clinicians.
Evidence-based review of vascular access team (VAT) outcomes: CLABSI reduction, first-attempt success rates, catheter-related complication reduction, cost savings, and return on investment data supporting dedicated vascular access specialist programs.
Complete guide to building, measuring, and governing a vascular access team (VAT) program: models, evidence, ROI calculation, quality metrics, scope of practice, and program governance.
Overview of vascular access clinical standards and regulatory framework: INS 2021 Standards of Practice, IDSA guidelines, CDC catheter guidelines, Joint Commission NPSG 07.04.01, CMS requirements.
Comprehensive guide to vascular access quality metrics: CLABSI rates and SIR benchmarking, first-attempt success rates, phlebitis rates, catheter utilization ratios, PICC appropriateness tracking, dwell time management, and building a vascular access quality dashboard.
The most comprehensive vascular access knowledge base for clinicians — evidence-based guides on PICC lines, CVCs, CLABSI prevention, complications, ultrasound, credentialing, and infusion therapy.
Clinical reference for vascular access in special populations: pediatric, NICU/neonatal, oncology, hemodialysis, critical care, geriatric, obese, and immunocompromised patients — device selection, technique modifications, and population-specific risks.
Complete guide to vascular access documentation requirements: insertion notes, daily assessment, infusion therapy documentation, complication recording, device removal, and EHR best practices per INS 2021.
Complete comparison of all vascular access device types: PIV, midline, PICC, CVC, tunneled catheter, port, hemodialysis catheter, IO, and arterial line — with a clinical selection guide.
Complete guide to vascular access credentialing and certification: VA-BC, CRNI, PICC insertion competency, ultrasound credentialing, institutional privileging, and building a credentialing program.
Complete guide to VA-BC (Vascular Access Board Certified) certification: eligibility requirements, exam content domains, application process, exam preparation, and recertification requirements through AVAR/CBVN.
Complete clinical reference on ultrasound-guided vascular access: evidence base, vascular anatomy, technique (short-axis vs long-axis), US-guided PIV, PICC, and CVC insertion, tip confirmation, and credentialing requirements.
Complete ultrasound-guided PICC insertion guide: pre-insertion vein survey, long-axis technique for basilic vein cannulation, guidewire US confirmation, catheter measurement, and intraoperative tip guidance with ECG.
Guide to ultrasound-guided peripheral IV for difficult venous access: DIVA score application, vein selection (diameter, depth), catheter length requirements, short-axis technique, common pitfalls, and when to escalate to midline or PICC.
Comprehensive guide to ultrasound technique for vascular access: probe selection, short-axis vs long-axis approach, in-plane vs out-of-plane needle guidance, dynamic vs static technique, and practical tips for needle visualization.
Implementation guide for ultrasound credentialing in vascular access programs: defining scope, training curriculum design, simulation, proctored cases, privileges documentation, maintenance, and program-level quality metrics.
Framework for ultrasound credentialing in vascular access: didactic requirements, simulation, proctored case minimums, competency assessment, scope of practice definitions, and maintenance of competency requirements per INS and AVAR.
Clinical guide to tunneled central venous catheters: Hickman, Broviac, and Groshong types, indications, care and maintenance, flushing protocols, complication management, and comparison with implanted ports.
Clinical decision guide comparing PICC, midline catheter, and non-tunneled CVC: indications, contraindications, osmolarity limits, dwell time, CLABSI risk, and evidence-based selection criteria per INS 2021 and MAGIC.
Evidence-based guide to PICC tip position verification: cavoatrial junction target, intraprocedural ECG guidance (P-wave method), post-procedure CXR interpretation, malposition recognition, and CEVAD standards.
The complete clinical reference on PICC lines: indications, ultrasound-guided insertion, CEVAD tip position standards, maintenance protocols, complications, and removal — evidence-based.
Complete step-by-step guide to ultrasound-guided PICC line insertion using the modified Seldinger technique: site selection, vein assessment, catheter measurement, sterile technique, and post-insertion verification.
Clinical indications for PICC line placement — appropriate and inappropriate criteria per INS 2021 and MAGIC, PICC for IV antibiotics, chemotherapy, TPN, and vesicants, and absolute contraindications.
Complete guide to PICC line complications: PICC-associated DVT (incidence, prevention, anticoagulation), CLABSI prevention, catheter occlusion (alteplase protocol), phlebitis, mechanical complications, and MARSI prevention.
Complete PICC care and maintenance guide: dressing change technique (CHG dressing, TSM, step-by-step), SASH flushing protocol, daily assessment requirements, patient education, and safe PICC removal procedure.
Complete PICC insertion competency framework: didactic training content, simulation requirements, proctored case minimums, competency checklist, privileges documentation, and annual competency maintenance requirements.
Complete guide to phlebitis in vascular access: types (mechanical, chemical, bacterial, post-infusion), INS VIP phlebitis scale, grading criteria, site-specific management, and prevention strategies per INS 2021.
Complete guide to pediatric peripheral IV access: age-specific site selection (neonate to adolescent), scalp vein placement in infants, pain management (EMLA, LMX, vapocoolant, sucrose), gauge selection, restraint considerations, and family-centered care.
Guide to vascular access requirements for parenteral nutrition (PN): central vs peripheral PN access criteria, osmolarity thresholds, PICC vs CVC for TPN, dedicated PN lumen, filtration requirements, administration set change intervals, and DEHP-free requirements.
Comprehensive guide to oncology vascular access: port vs PICC decision-making, chemotherapy central access requirements, vesicant administration, CLABSI prevention in neutropenic patients, power-injectable port selection, and access management across the cancer treatment continuum.
Complete clinical guide to non-tunneled central venous catheters: site selection (IJ vs subclavian vs femoral), ultrasound-guided insertion, complications (pneumothorax, hemothorax, arterial injury), CLABSI prevention, and removal.
Complete NICU vascular access guide: umbilical arterial and venous catheters (UAC/UVC), neonatal PICC lines, neonatal peripheral IV, gestational age considerations, skin protection, heparin-free protocols, and light protection for neonatal PN.
Evidence-based guide to needleless connectors and CLABSI prevention: connector types (split-septum, mechanical valve), scrub-the-hub technique, change intervals, passive disinfection caps, and selecting connectors to minimize CLABSI risk.
Framework for building an institutional vascular access privileging program: scope of practice delineation, privilege categories, competency documentation, re-privileging, medical staff credentialing vs. nursing competency, and TJC compliance.
Complete clinical reference on infusion therapy safety: filtration standards, flushing and locking, vesicant administration, high-alert medications, PN access requirements, administration set management, and smart pump safety.
Complete guide to infusion filtration requirements: 0.2 micron vs 1.2 micron filter selection, medications requiring filtration, medications that cannot be filtered, TPN filtration requirements, and air-eliminating filter standards per INS 2021.
Complete guide to IV infiltration and extravasation: INS infiltration staging scale (0–4), vesicant vs. non-vesicant injury, antidote table (dexrazoxane, hyaluronidase, phentolamine), emergency response, and prevention.
Complete clinical guide to implanted vascular access ports: port anatomy, Huber needle access technique, ANTT flushing and locking protocol, power-injectable ports, port complications, and deaccess procedure.
Clinical guide to high-alert IV medications: ISMP list of high-alert medications in vascular access, safety protocols for concentrated KCl, heparin, insulin, opioids, neuromuscular blockers, and chemotherapy — with required safeguards.
Clinical guide to hemodialysis vascular access: AVF creation and maturation criteria, AV graft cannulation, tunneled dialysis catheter placement and complications, vessel preservation in CKD/ESRD, fistula-first policy, buttonhole vs rope-ladder technique, and catheter-to-fistula transition.
Clinical guide to hemodialysis vascular access: AV fistula (preferred), AV graft, and tunneled hemodialysis catheter — indications, care, complications, the access hierarchy, and vessel preservation for CKD patients.
Evidence-based guide to vascular access device flushing and locking: SASH protocol (Saline-Administer-Saline-Heparin), pulsatile flush technique, positive pressure locking, heparin vs saline evidence, flush volumes, and device-specific protocols.
Evidence-based vascular access device selection using INS 2021 standards, the Vessel Health and Preservation (VHP) framework, DIVA score, osmolarity thresholds, and the MAGIC appropriateness criteria.
CVAD tip location standards per CEVAD 2020 consensus: cavoatrial junction target, radiographic landmarks, device-specific tip positions, tip confirmation methods (ECG, CXR, fluoroscopy), and malposition classification.
Complete guide to CRNI (Certified Registered Nurse Infusion) certification: eligibility requirements, exam content domains, application process, CRNI vs VA-BC comparison, and recertification.
Clinical guide to critical care vascular access: CVC site selection in the ICU, arterial line placement and management, vasopressor central access requirements, CRRT/CVVHD access, pulmonary artery catheter, CLABSI prevention in the ICU, and simultaneous multi-device management in the critically ill.
The complete evidence-based CLABSI prevention guide: CDC/NHSN definitions, insertion bundle, maintenance bundle, CHG bathing, antimicrobial strategies, surveillance, and Zero CLABSI implementation.
Complete guide to the CLABSI maintenance bundle: scrub-the-hub technique, CHG-impregnated dressings, CHG daily bathing, needleless connector management, administration set change intervals, and daily necessity review per INS 2021 and CDC guidelines.
Evidence-based guide to the CLABSI insertion bundle: 5 elements (hand hygiene, maximal sterile barrier, CHG antisepsis, optimal site selection, daily necessity review), implementation, and bundle compliance documentation.
Complete overview of CLABSI definition (NHSN criteria), epidemiology (incidence, mortality, cost), CLABSI vs CRBSI distinction, NHSN surveillance methodology, SIR benchmarking, and how CLABSI rates are calculated.
Evidence-based guide to chlorhexidine gluconate (CHG) in CLABSI prevention: skin antisepsis (2% CHG vs povidone-iodine), CHG-impregnated dressings, daily CHG bathing, application technique, dry time requirements, and CHG safety considerations.
Complete clinical reference on central venous catheters: non-tunneled CVCs (IJ, subclavian, femoral), tunneled catheters (Hickman, Broviac, Groshong), implanted ports, dialysis catheters, and CVAD tip location standards.
Complete clinical guide to catheter-associated thrombosis: PICC-associated UEDVT (incidence, risk factors, diagnosis), fibrin sheath, treatment options (anticoagulation, catheter removal decision), and prevention strategies.
Complete clinical guide to catheter occlusion management: occlusion types (thrombotic, non-thrombotic, mechanical), alteplase protocol (2 mg/2 mL), troubleshooting approach, non-thrombotic occlusion management, and prevention with SASH flushing.
Guide to CVAD malposition types, recognition, and management: primary malposition (at insertion), secondary malposition (tip migration), IJ, azygos, subclavian, and RA malpositions, repositioning techniques, and prevention.
Complete clinical reference on catheter complications: thrombosis, occlusion, phlebitis, infiltration, extravasation, air embolism, malposition, and skin injury — recognition, prevention, and evidence-based management.
Evidence-based guide to antimicrobial-impregnated catheters (CHG/SS, minocycline-rifampin), antimicrobial dressings, and antimicrobial lock therapy for CLABSI prevention in high-risk settings — indications, evidence, and limitations.
Complete guide to air embolism in vascular access: pathophysiology, prevention during insertion and removal, recognition of venous air embolism, emergency management (Durant's maneuver, aspiration, oxygen therapy), and high-risk scenarios.