Vascular Viewpoints

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Sean Lau, RN, VA-BC What are some ways we can reduce the prevalence of difficult venous access? Dr. Charles Turck is joined by Sean Lau, a vascular access specialist at Stanford Health Care, to share strategies to help reduce DIVA rates and improve vascular access care.

Host: Jennifer Caudle, DO Guest: Cheryl Campos, DNP, RN-BC, CEN, CPHQ Difficult IV access (DIVA) is a term used to describe patients who require multiple attempts to cannulate a vein. And since the prevalence of DIVA can be as high as 59 percent, Dr. Jennifer Caudle speaks with Dr. Cheryl Campos about how we can better identify high-risk patients, how we can manage DIVA patients, and more.

Host: Jennifer Caudle, DO Guest: Fulvio Pinelli, M.D., M.Sc. For patients who've undergone an emergency cardiac procedure, the transition from emergency room to doctor's office may be challenging. What can we do to bridge those vascular access gaps beyond the emergency setting? Dr. Jennifer Caudle is joined by Dr. Fulvio Pinelli, the director of the Vascular Access Center at the Careggi University Hospital in Florence Italy, to share some strategies for maintaining continuity of care.

Host: Paul Doghramji, MD Guest: Nadine Nakazawa, RN, BS How does the patient-centric experience model for vascular access care differ from what we're used to doing, and what does it actually look like in practice? Joining Dr. Paul Doghramji to share what we need to know about the development and goals of patient-centered vascular access care is Ms. Nadine Nakazawa, a vascular access nurse specialist at Stanford Health Care.

Host: Jennifer Caudle, DO Guest: Kelly Cawcutt, MD How has the COVID-19 pandemic changed vascular access paradigms in the intensive care unit? Joining Dr. Jennifer Caudle to share her story and lessons learned from the pandemic is Dr. Kelly Cawcutt, an Assistant Professor in the Department of Internal Medicine and the Associate Medical Director of Infection Control and Epidemiology at the University of Nebraska Medical Center.

Host: Hector O. Chapa, MD Guest: Andrew Little, DO When vascular access is compromised, intraosseous access, or IO access, can help prevent fatal consequences. What do we need to know about implementing and managing this type of device? Dr. Hector Chapa is joined by Dr. Andy Little, the Associate Program Director for AdventHealth Orlando Emergency Medicine Residency, to share some insight on IO vascular access.

Host: Jennifer Caudle, DO Guest: Rachel Liu, BAO, MBBCh, FACEP, FAIUM Diagnostic tools like chest x-rays and ultrasounds have been instrumental in detecting and preventing pneumothorax, but is one approach better than another? Dr. Rachel Liu is here to answer that question and more.

Host: Jennifer Caudle, DO Guest: Paolo Balsorano, MD Guest: Gregory J. Schears, MD While peripherally inserted central catheters (PICCs) and centrally inserted central catheters (CICCs) are commonly used to administer intravenous therapy, they can cause serious complications, such as deep vein thrombosis (DVT) and central line-associated bloodstream infections (CLABSI). With these risks in mind, Drs. Gregory Schears and Paolo Balsorano share the latest research on DVT and CLABSI outcomes associated with the use of PICCs and CICCs.

Host: Matt Birnholz, MD Guest: Marcia Ryder, PhD MS RN Which drugs are peripherally compatible, which infusion timelines should be observed, and which infusate properties increase complication risks are some of the most common confusion points around catheter failure risks. To help us sort through them, Dr. Marcia Ryder joins Dr. Matt Birnholz to discuss her study on risk factors for midline catheter failures.

Host: Jennifer Caudle, DO Guest: Brian Boer, MD Guest: Grant Fabry How can critical care physicians and nurses improve care coordination for acute dialysis patients in the ICU? Joining Dr. Jennifer Caudle to answer that and other questions are two guests from the University of Nebraska Medical Center (UNMC): Dr. Brian Boer, Assistant Professor of Internal Medicine in the Division of Pulmonary, Critical Care, Sleep, and Allergy, and Grant Fabry, an ICU nurse and Clinical Instructor at UNMC’s College of Nursing.

Host: Jennifer Caudle, DO Guest: Brian Boer, MD When critically ill patients develop acute kidney failure in the ICU, how do you go about choosing the right catheter option for them? Here to weigh the pros and cons of different catheter options for acute dialysis procedures is Dr. Brian Boer, Assistant Professor of Internal Medicine in the Division of Pulmonary, Critical Care, Sleep, and Allergy at the University of Nebraska Medical Center.

Host: Matt Birnholz, MD Guest: April Taylor, MS, MHA, CPPS, CPHQ If you find HAC scores confusing, you’re certainly not alone. In fact, disparities often exist between hospital administrations, departments, and clinicians when it comes to understanding how HAC scores are constructed and which practices influence them the most. To help clear up some of the confusion, Dr. Matt Birnholz is joined by Senior Director of Improvement and Project Management at the Children’s Hospital of Philadelphia Ms. April Taylor.

Host: Matt Birnholz, MD Guest: April Taylor, MS, MHA, CPPS, CPHQ Adhering to HAC score protocols is extremely important for institutions, but not to the extent that they should be prioritized over patient preferences. Here to walk us through the risks and downstream impacts of prioritizing HAC scores over our vascular access patients’ needs is senior director of Children’s Hospital of Philadelphia, April Taylor.

Host: Matt Birnholz, MD Guest: Kelly Cawcutt, MD During this unprecedented time when there are still many unknowns surrounding COVID-19, collaborating with other clinicians across the entire world is essential. Tune in as Dr. Kelly Cawcutt, an infectious disease and critical care physician at the University of Nebraska Medical Center, explains American and international collaborations toward vascular access innovations to help combat COVID-19. Published May 7, 2020

Host: Matt Birnholz, MD Guest: Kelly Cawcutt, MD During this unprecedented time when there are still many unknowns surrounding COVID-19, collaborating with other clinicians across the entire world is essential. Tune in as Dr. Kelly Cawcutt, an infectious disease and critical care physician at the University of Nebraska Medical Center, explains American and international collaborations toward vascular access innovations to help combat COVID-19. Published May 7, 2020

Host: Matt Birnholz, MD Guest: Kelly Cawcutt, MD Adapting to the drastic changes COVID-19 has forced clinicians to make is one of the many obstacles faced during this pandemic. Joining Dr. Matt Birnholz to talk about how vascular access teams are changing their protocols and roles in response to COVID-19 is Dr. Kelly Cawcutt, an infectious disease and critical care physician at the University of Nebraska Medical Center. Published May 5, 2020

Host: Matt Birnholz, MD Guest: Kelly Cawcutt, MD Adapting to the drastic changes COVID-19 has forced clinicians to make is one of the many obstacles faced during this pandemic. Joining Dr. Matt Birnholz to talk about how vascular access teams are changing their protocols and roles in response to COVID-19 is Dr. Kelly Cawcutt, an infectious disease and critical care physician at the University of Nebraska Medical Center. Published May 5, 2020

Host: Matt Birnholz, MD Guest: Mauro Pittiruti, MD Throughout the COVID-19 pandemic, it’s become clear that a lot of changes were needed in ICU settings to better respond to the special needs of patients. To find out how ICUs in one of the hardest-hit countries have responded, Dr. Matt Birnholz speaks with Dr. Mauro Pittiruti, surgeon and professor at the Catholic University Hospital in Rome. Published May 1, 2020 Please visit https://gavecelt.it/nuovo/ where you can locate the GAVeCeLT guidelines, which is available in 6 different languages! If you have any questions on the content of the epsiodes please reach us at covid19@reachmd.com. Mauro Pittiruti, MD- Catholic University Hospital, Rome - Italy

Host: Matt Birnholz, MD Guest: Mauro Pittiruti, MD Throughout the COVID-19 pandemic, it’s become clear that a lot of changes were needed in ICU settings to better respond to the special needs of patients. To find out how ICUs in one of the hardest-hit countries have responded, Dr. Matt Birnholz speaks with Dr. Mauro Pittiruti, surgeon and professor at the Catholic University Hospital in Rome. Published May 1, 2020 Please visit https://gavecelt.it/nuovo/ where you can locate the GAVeCeLT guidelines, which is available in 6 different languages! If you have any questions on the content of the epsiodes please reach us at covid19@reachmd.com. Mauro Pittiruti, MD- Catholic University Hospital, Rome - Italy

Host: Matt Birnholz, MD Guest: Marcia Ryder, PhD MS RN Algorithm-based care has become a standard for vascular access teams as it provides evidence-based protocols for matching vascular access device selections with appropriate clinical settings. Here to walk us through where these algorithms originated, how they compare and contrast, and other key considerations is Dr. Marcia Ryder.

Host: Matt Birnholz, MD Guest: Mauro Pittiruti, MD In response to the COVID-19 pandemic, the GaVeCelt recommendations for vascular access in critical care settings were recently updated. Joining Dr. Matt Birnholz to review those updates is Dr. Mauro Pittiruti, Founder and President of the Italian Group of Central Venous Access, which is the expert consensus group responsible for issuing the GAVeCeLT recommendations. Published April 30, 2020 Please visit https://gavecelt.it/nuovo/ where you can locate the GaVeCeLT guidelines, which is available in 6 different languages! If you have any questions on the content of the episodes, please reach us at covid19@reachmd.com. Mauro Pittiruti, MD- Catholic University Hospital, Rome - Italy

Host: Matt Birnholz, MD Guest: Marcia Ryder, PhD MS RN Algorithm-based care has become a standard for vascular access teams as it provides evidence-based protocols for matching vascular access device selections with appropriate clinical settings. Here to walk us through where these algorithms originated, how they compare and contrast, and other key considerations is Dr. Marcia Ryder.

Host: Matt Birnholz, MD Guest: Mauro Pittiruti, MD In response to the COVID-19 pandemic, the GaVeCelt recommendations for vascular access in critical care settings were recently updated. Joining Dr. Matt Birnholz to review those updates is Dr. Mauro Pittiruti, Founder and President of the Italian Group of Central Venous Access, which is the expert consensus group responsible for issuing the GAVeCeLT recommendations. Published April 30, 2020 Please visit https://gavecelt.it/nuovo/ where you can locate the GaVeCeLT guidelines, which is available in 6 different languages! If you have any questions on the content of the episodes, please reach us at covid19@reachmd.com. Mauro Pittiruti, MD- Catholic University Hospital, Rome - Italy

Host: Amy Mackey, MD Guest: Salim Rezaie, MD Guest: Evan Alexandrou, MD By reducing time to therapy, eliminating the need for confirmatory chest x-rays, and reducing the costs associated with these procedures, PICC catheter tip positioning and confirmation using electrocardiogram is revolutionizing vascular access device insertion. To learn more about this technology, Dr. Amy Mackey is joined by Drs. Evan Alexandrou and Salim Rezaie, who share how it works, its use with acute CVCs and dialysis catheters placed in the internal jugular and subclavian veins, and more.

Host: Amy Mackey, MD Guest: Salim Rezaie, MD Guest: Evan Alexandrou, MD By reducing time to therapy, eliminating the need for confirmatory chest x-rays, and reducing the costs associated with these procedures, PICC catheter tip positioning and confirmation using electrocardiogram is revolutionizing vascular access device insertion. To learn more about this technology, Dr. Amy Mackey is joined by Drs. Evan Alexandrou and Salim Rezaie, who share how it works, its use with acute CVCs and dialysis catheters placed in the internal jugular and subclavian veins, and more.

Host: Amy Mackey, MD Guest: Andrew Little, DO Since options for difficult intravenous (IV) access cases are still often limited in many emergency departments, vascular access care teams are strategizing easier solutions. Join Amy Mackey as she speaks with Dr. Andrew Little about novel approaches to these challenging cases, like the Easy IJ procedure.

Host: Amy Mackey, MD Guest: Andrew Little, DO Since options for difficult intravenous (IV) access cases are still often limited in many emergency departments, vascular access care teams are strategizing easier solutions. Join Amy Mackey as she speaks with Dr. Andrew Little about novel approaches to these challenging cases, like the Easy IJ procedure.

Host: Jennifer Caudle, DO Guest: Nadine Nakazawa, RN, BS PICC-related complications should be at the forefront of the minds of any vascular access team, which is why Nadine Nakazawa, a vascular access specialist at Stanford Health Care in California, is here to talk about what the latest evidence-based recommendations say about avoiding them.

Host: Jennifer Caudle, DO Guest: Nadine Nakazawa, RN, BS In the face of challenging vascular access situations, we typically turn to available evidence to help us make sound decisions, but what happens when that same evidence is interpreted differently across vascular access teams and institutions? To help address this interpretative gap in vascular access care evidence, Dr. Jennifer Caudle is joined by Nadine Nakazawa, a vascular access specialist at Stanford Health Care in California.

Host: Jennifer Caudle, DO Guest: Nadine Nakazawa, RN, BS PICC-related complications should be at the forefront of the minds of any vascular access team, which is why Nadine Nakazawa, a vascular access specialist at Stanford Health Care in California, is here to talk about what the latest evidence-based recommendations say about avoiding them.

Host: Jennifer Caudle, DO Guest: Nadine Nakazawa, RN, BS In the face of challenging vascular access situations, we typically turn to available evidence to help us make sound decisions, but what happens when that same evidence is interpreted differently across vascular access teams and institutions? To help address this interpretative gap in vascular access care evidence, Dr. Jennifer Caudle is joined by Nadine Nakazawa, a vascular access specialist at Stanford Health Care in California.

Host: Matt Birnholz, MD Guest: Andrew Little, DO Even though the internal jugular vein is often used in central vascular access procedures, there are still some knowledge gaps surrounding this type of line placement. Joining Dr. Matt Birnholz to review best practices, risk mitigation strategies, and device selection criteria for internal jugular procedures is Dr. Andrew Little, an emergency medicine specialist at OhioHealth Doctors Hospital in Columbus, Ohio.

Host: Matt Birnholz, MD Guest: Andrew Little, DO Even though the internal jugular vein is often used in central vascular access procedures, there are still some knowledge gaps surrounding this type of line placement. Joining Dr. Matt Birnholz to review best practices, risk mitigation strategies, and device selection criteria for internal jugular procedures is Dr. Andrew Little, an emergency medicine specialist at OhioHealth Doctors Hospital in Columbus, Ohio.

Host: Jennifer Caudle, DO Guest: Bret Nelson, MD Guest: Matthew Ostroff, NP With new medical technology and techniques on the rise, all healthcare professionals want first dibs on viewing them on social media. But how does social media affect patients’ perspectives on these advancements? Here to explore this hot topic with Dr. Jennifer Caudle are Dr. Bret Nelson and advanced nurse practitioner Matt Ostroff.

Host: Matthew Ostroff, NP Guest: Bret Nelson, MD With a patient's life on the line, vascular access care teams need to work together to structure the right treatment by using the right device. Listen in as Dr. Bret Nelson and advanced nurse practitioner Matt Ostroff discuss two complex cases and the obstacles they had to overcome to give these patients proper treatment.

Host: Mario R. Nacinovich, Jr., MSc Guest: Kelly Cawcutt, MD If you’re looking to adopt a patient-centered approach into your own practice, tune in to hear Dr. Kelly Cawcutt, an infectious disease and critical care physician at the University of Nebraska Medical Center, break down her team’s approach with Mario Nacinovich.

Guest: Kelly Cawcutt, MD Sharing a patient story from her own experience as an infectious disease and critical care physician, Dr. Kelly Cawcutt reflects on the choice of vascular access, the decision-making process, and the risks and benefits of different types of vascular devices.

Host: Jennifer Caudle, DO Guest: Bret Nelson, MD Guest: Matthew Ostroff, NP With new medical technology and techniques on the rise, all healthcare professionals want first dibs on viewing them on social media. But how does social media affect patients’ perspectives on these advancements? Here to explore this hot topic with Dr. Jennifer Caudle are Dr. Bret Nelson and advanced nurse practitioner Matt Ostroff.

Host: Matthew Ostroff, NP Guest: Bret Nelson, MD With a patient's life on the line, vascular access care teams need to work together to structure the right treatment by using the right device. Listen in as Dr. Bret Nelson and advanced nurse practitioner Matt Ostroff discuss two complex cases and the obstacles they had to overcome to give these patients proper treatment.

Host: Mario R. Nacinovich, Jr., MSc Guest: Kelly Cawcutt, MD If you’re looking to adopt a patient-centered approach into your own practice, tune in to hear Dr. Kelly Cawcutt, an infectious disease and critical care physician at the University of Nebraska Medical Center, break down her team’s approach with Mario Nacinovich.

Guest: Kelly Cawcutt, MD Sharing a patient story from her own experience as an infectious disease and critical care physician, Dr. Kelly Cawcutt reflects on the choice of vascular access, the decision-making process, and the risks and benefits of different types of vascular devices.

Guest: Wes Ely, MD, MPH Between choosing the right vascular access device, maintaining interprofessional communication, and asking the right questions, there’s a lot that goes into developing a patient-centered approach. Here to review these three essential elements in greater detail is Dr. Wes Ely, Professor of Medicine and Co-Director of the CIBS Center at Vanderbilt University School of Medicine Content for this series is produced and controlled by ReachMD.