This week’s post is a podcast covering an unfeasible amount of chat on a challenge in paediatric anaesthesia that takes up plenty of time – peripherally inserted central catheters (PICCs).

Don’t look at us like that.

Andrew Weatherall is joined by Dr Hillel Hope to cover a bit about why we’re asked to put them in, choosing a line, complications, insertion practice and troubleshooting. This covers a lot of Hillel’s experience which might not be direct advice, but will hopefully get you thinking about how to do things locally wherever you work.

Anyway, here it is.

Right click and choose save as to download the podcast. (That’s control-click if you’re on a trusty Mac.)

Of course you could just find the podcast over at iTunes here.

Or the rss feed is here.

Don’t forget that if you like the site you can choose to follow via e-mail and each time a post goes up you’ll get a link.

In the meantime, Hillel offered a bunch of references to consider because going to the literature is always best.

Westergaard B, Classen V, Walther-Larsen S. Peripherally inserted central catheters in infants and children – indications, techniques, complications and clinical recommendations. Acta Anaesthesiol Scand 2013;57:278-87.

Bourgeois FC, Lasagna P, Chiang VW. Peripherally inserted central catheters. Pediatr Emerg Care. 2011;27:556-61.

Bramwell LE, Peripherally inserted central catheter placement in infants and children. Tech Vasc Interv Radiol. 2011;14:204-11.

Johnston AJ, Bishop SM, Martin L, See TC, Streater CT. Defining peripherally inserted central catheter tip position and an evaluation of insertions in one unit. Anaesthesia. 2013;68:484-91.

Juhani K, Advani S, Reich NG, Gosey L, Milstone AM. Risk factors for peripherally inserted central venous catheter complications in children. JAMA Pediatr. 2013;167:429-35.

Chopra V, Anand S, Hickner A, Buist M, Rogers MA, Saint S, Flanders SA. Risk of venous thromboembolism associated with peripherally inserted central catheters: a systematic review and meta-analysis. Lancet 2013;382:311-25.

Barrier A, Williams DJ, Connelly M, Buddy Creech C. Frequency of Peripherally Inserted Central Catheter Complications in Children. Pediatr Infect Dis J .2012;31:519-21. 

And a couple of other notes:

The image of that underwhelmed eagle owl is unaltered from the image posted under Creative Commons by Airwolfhound on flickr

At the end of the podcast there is also a track by Blank and Kytt called RSPN which is off their Heavy, Crazy, Serious album which they posted at the Free Music Archive, also under a Creative Commons license. It’s unchanged.