Vascular Access Latest Topicshttps://pediatricsurgeryclub.com/forum/157-vascular-access/Vascular Access Latest Topicsen9/11/2025https://pediatricsurgeryclub.com/topic/3466-9112025/[size=6]A 5-week-old 3 kg infant is in the ED with bilious emesis. The infant is lethargic and dehydrated. The ED has not been able to obtain peripheral IV access. What is the best next step to secure urgent vascular access?

 

a Saphenous vein catheter

 

b Umbilical vein catheter

 

c Intraosseous access

 

d Internal jugular vein catheter[/size]

]]>3466Sun, 09 Nov 2025 13:33:10 +0000illustrated paper: Totally implantable venous access portshttps://pediatricsurgeryclub.com/topic/1801-illustrated-paper-totally-implantable-venous-access-ports/Any one want a high quality PDF of this chart, post in this thread, use a personalized picture as an avatar, and have three threads in the forums, I will send it to you in a private message

 

Edit: available without restrictions

 

 

[color=#3300ff]JournalClub.png.36eea15c293f168325a75a787ec394e8.png[/color]

]]>1801Wed, 10 Feb 2021 16:02:06 +0000Pediatric Hemodialysis Accesshttps://pediatricsurgeryclub.com/topic/3325-pediatric-hemodialysis-access/repview(1).jpg.1262acea44746f927a706b97efb05372.jpg]]>3325Sun, 05 Jan 2025 11:52:59 +00008/9/2024https://pediatricsurgeryclub.com/topic/3230-892024/An 8 year-old girl requires exchange of her existing left internal jugular port-a-catheter to a hemodialysis catheter due to a failing renal transplant. She has a history of multiple previous hemodialysis catheters and central venous stenosis. During catheter placement, serial dilations of the central venous stenosis are performed over a wire and she becomes hypotensive and bradycardic. Her heart rate and blood pressure (60/40) improve with epinephrine and the last fluoroscopic image is shown below. What is the best next step in management?

 

611AA2DE-1E47-4998-839A-DBBCA5007F85.jpg.4d585e0ccb5c80127179653add05b2f4.jpg

 

[size=20px]A Echocardiogram

 

B Insert a right chest tube

 

C Right thoracotomy

 

D Left thoracotomy

 

E Median sternotomy[/size]

]]>3230Sun, 08 Sep 2024 10:58:11 +00004/8/2024https://pediatricsurgeryclub.com/topic/3196-482024/[size=20px]Compared to centrally inserted venous catheters, peripheral inserted central catheters (PICCs) are associated with a higher rate of

 

a catheter patency.

 

b catheter fracture.

 

c central line associated blood stream infection (CLABSI).

 

d deep venous thrombosis.

 

e pulmonary embolism.[/size]

]]>3196Sun, 04 Aug 2024 12:23:24 +0000dialysis access methodshttps://pediatricsurgeryclub.com/topic/3138-dialysis-access-methods/repview(2).jpg.ead74c58f00c913db8de4b522c7738ed.jpg]]>3138Sun, 31 Mar 2024 11:31:28 +0000Manifestations of Pneumothorax post central line insertionhttps://pediatricsurgeryclub.com/topic/3044-manifestations-of-pneumothorax-post-central-line-insertion/F9CBB5B3-2301-4E0F-BEB8-DCF50AE09DA8.jpg.8d65e8468082e72f84d76812ae6f6616.jpg]]>3044Thu, 23 Nov 2023 07:43:13 +0000Open CVP Catheter Insertionhttps://pediatricsurgeryclub.com/topic/1689-open-cvp-catheter-insertion/

[center]

Open CVP Catheter Insertion. Internal jugular vein Cutdown. By Dr Tamer Ashraf Wafa, PhD, MRCS

see in next post

[/center]

]]>1689Wed, 09 Dec 2020 04:45:24 +0000Pediatric Vascular Access in Briefhttps://pediatricsurgeryclub.com/topic/2830-pediatric-vascular-access-in-brief/see video link in second post

 

2023-01-23_16-01-59.jpg.ed9cf7f1af0dd98a6d8145b551c3b798.jpg

]]>2830Mon, 23 Jan 2023 13:05:06 +0000Neonatal Femoral central line via Venotomy techniquehttps://pediatricsurgeryclub.com/topic/2711-neonatal-femoral-central-line-via-venotomy-technique/see video link in second post

 

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]]>2711Fri, 06 May 2022 08:16:09 +0000Porta cath insertionhttps://pediatricsurgeryclub.com/topic/2513-porta-cath-insertion/see video link in second post

 

2021-11-23_12-15-03.jpg.6bd44bd78f4d3eac838211a86e6e3bd5.jpg

]]>2513Tue, 23 Nov 2021 09:16:50 +0000Central Venous Accesshttps://pediatricsurgeryclub.com/topic/1915-central-venous-access/see in next post

 

2021-03-15_10-44-02.jpg.6c134fe28e5c0442546c2fcad646a6eb.jpg

]]>1915Mon, 15 Mar 2021 07:45:08 +0000difficult port removal casehttps://pediatricsurgeryclub.com/topic/1614-difficult-port-removal-case/First one with correct answer with justification win.

 

[size=20px]A nine-year old boy has completed treatment for acute lymphoblastic leukemia. An implanted resevoir for vascualr access was placed via a percutaneous left subclavian vein approach four years prior. A request was made for its removal by the Hematology-Oncology Service. At surgery, the port was mobilized without difficulty. However, the catheter could not be withdrawn despite a prolonged attempt at providing tension on the catheter. Dissection was undertaken to the infraclavicular area but the catheter could still not be withdrawn.

 

The next best step in management of this child with a difficult port removal is

 

A remove the port, ligate the catheter at its insertion and leave in place.

 

B leave the port and catheter in place.

 

C remove the port, ligate and suture the catheter to surrounding tissue at the insertion site.

 

D expose the subclavian vein for catheter removal.

 

E ligate the catheter and send the patient to interventional radiology for emergent removal.[/size]

]]>1614Fri, 06 Nov 2020 11:13:25 +0000Patient IPSO Practice Guidelines on Venous Access for the Pediatric Cancer Patienthttps://pediatricsurgeryclub.com/topic/1575-patient-ipso-practice-guidelines-on-venous-access-for-the-pediatric-cancer-patient/[b]IPSO Practice Guidelines on Venous Access

for the Pediatric Cancer Patient[/b]

]]>1575Tue, 20 Oct 2020 22:22:50 +0000Hypotension post left internal jugular dialysis catheter insertionhttps://pediatricsurgeryclub.com/topic/1528-hypotension-post-left-internal-jugular-dialysis-catheter-insertion/First one with correct answer with justification win.

 

[size=20px]Upon emergence from general anesthesia after percutaneous placement of a left internal jugular dialysis catheter, a patient is noted to be hypotensive with a blood pressure of 70/50 and increased central venous pressure. Breath sounds are equal bilaterally but jugular veins are distended with muffled heart tones. The next best step in management of this patient with hypotension is

 

A fluid resuscitation.

 

B vasopressors.

 

C pericardiocentesis.

 

D echocardiography.

 

E tube thoracostomy.[/size]

]]>1528Tue, 06 Oct 2020 06:46:42 +0000