Use of C-Arm Fluoroscopy by Nurses for Placement of PICC Lines

2009 ◽  
Vol 14 (3) ◽  
pp. 138-141 ◽  
Author(s):  
Barry Royce
Keyword(s):  
Medical Center ◽  
University Of Minnesota ◽  
Machine Maintenance ◽  
Department Of Health ◽  
Line Insertion ◽  
Proper Training ◽  
Picc Line ◽  
The University ◽  
High Degree ◽  
Healing Arts

Abstract The Minnesota Department of Health Ionizing Radiation Rules “prohibits the use of fluoroscopy by a person other than a licensed practitioner of the healing arts... when the licensed practitioner of the healing arts is not physically present in the room” (Minnesota Administrative Rules, 2007). Getting a licensed practitioner into the room caused delays in completing PICC line insertion procedures. To minimize these delays we considered multiple options; one of the options was to have PICC nurses licensed to operate the fluoroscopy machine. This article will explain the process the Vascular Access Department at the University of Minnesota Medical Center, Fairview went through to make this option a reality. Our team has demonstrated that with proper training, education, machine maintenance and completion of competencies, nurses can operate fluoroscopy independently and clear PICC lines for use with a high degree of safety, efficiency and accuracy.

Functional Limitations of Patients with End-Stage Ankle Arthrosis

2005 ◽  
Vol 26 (7) ◽  
pp. 537-539 ◽  
Author(s):  
Julie Agel ◽  
J. Chris Coetzee ◽  
Bruce J. Sangeorzan ◽  
Matthew M. Roberts ◽  
Sigvard T. Hansen
Keyword(s):  
Medical Center ◽  
Functional Limitations ◽  
Population Sample ◽  
Operative Management ◽  
The United States ◽  
University Of Minnesota ◽  
Previous Trauma ◽  
End Stage ◽  
The University ◽  
Foot Fractures

Background: Arthritis and other rheumatic conditions are the leading causes of disability among adults in the United States. The purpose of this report was to describe the self-reported functional limitations of a group of patients with end-stage ankle arthrosis. Method: Patients who presented for operative management of end-stage ankle arthrosis at the University of Minnesota and Harborview Medical Center completed a Musculoskeletal Functional Assessment (MFA) as part of their preoperative clinical evaluation. Data from patients evaluated during the time period April, 1995, through May, 2004, were used for this project. Results: Four hundred and twenty-six patients with the diagnosis of end-stage ankle arthrosis completed baseline questionnaires. Six of the 426 patients received care on both ankles during the time of this project. The average age of patients at the time of completion of the questionnaire was 56.7 years. There were 241 men and 185 women. The primary underlying causes identified by the treating surgeon at the time of surgery were primary osteoarthritis with no known prior trauma (66), previous trauma (tibial fracture, foot fractures, or ankle ligamentous disruption) (296), rheumatoid arthritis (24), no known cause (21), and a variety of diseases or infections (19). In all domains, the patients with end-stage ankle arthrosis showed statistically significant differences from a general population sample. Conclusions: The effects of ankle arthritis as demonstrated by this data are severe. Most of these patients were severely limited in function. Without a data-driven understanding of the limitations the patients have, it is difficult to make an effective argument for focused research to solve the problems. Without understanding the patients' needs, it is impossible to assess the effect of treatment. The information in this paper provides a baseline understanding of effect of the current functional limitations of patients with end-stage ankle arthrosis.

Interview with Apostolos P. Georgopoulos

1998 ◽  
Vol 10 (5) ◽  
pp. 657-661
Keyword(s):  
Medical Center ◽  
Veterans Affairs ◽  
University Of Minnesota ◽  
American Legion ◽  
Brain Sciences ◽  
The University

APG studied Medicine and Physiology at the University of Athens in Greece where he obtained his M.D. and Ph.D. degrees. He was trained in neurophysiology by Vernon B. Mountcastle at Johns Hopkins and, after a brief return to Athens, he came back to Johns Hopkins. He ascended the faculty ranks and promoted to Professor of Neuroscience in 1986. He was a member of the Philip Bard Laboratories of Neuro-physiology at the Department of Neuroscience until 1991 when he moved to Minnesota as the American Legion Brain Sciences Chair at the Minneapolis Veterans Affairs Medical Center and the University of Minnesota.

scholarly journals Infection Control During Gastrointestinal Endoscopy

2007 ◽  
Vol 21 (1) ◽  
pp. 13-15 ◽  
Author(s):  
Douglas B Nelson ◽  
Paul C Adams
Keyword(s):  
Infection Control ◽  
Gastrointestinal Endoscopy ◽  
Medical Center ◽  
Lead Author ◽  
University Of Minnesota ◽  
Staff Physician ◽  
The Subject ◽  
The University ◽  
Society Guideline

Dr Douglas Nelson is a staff physician in the department of gastroenterology at the Minneapolis VA Medical Center (Minnesota, USA) and a Professor of Medicine at the University of Minnesota (USA). He has written numerous articles on the subject of infection control during gastrointestinal endoscopy, and was the lead author of the "Multi-society guideline for reprocessing flexible gastrointestinal endoscopes" (1).

scholarly journals 52: Validation of the 30-Minute Rule at the University of Minnesota Medical Center: An Institutional Perspective

2015 ◽  
Vol 143 (suppl_1) ◽  
pp. A026-A026
Author(s):  
Ryan J Morse ◽  
Andrew D Johnson ◽  
Rebecca L Dangerfield ◽  
Claudia S Cohn ◽  
Keyword(s):  
Medical Center ◽  
University Of Minnesota ◽  
Institutional Perspective ◽  
The University

The Development of an Academic Medical Center in Rochester

2015 ◽  
Author(s):  
W. Bruce Fye
Keyword(s):  
Postgraduate Training ◽  
Medical Center ◽  
Academic Medical Center ◽  
The United States ◽  
Twin Cities ◽  
University Of Minnesota ◽  
Fellowship Program ◽  
Mayo Foundation ◽  
Academic Medical ◽  
The University

In 1915 the Mayo brothers created the Mayo Foundation for Medical Education and Research and established a formal relationship with the University of Minnesota, located ninety miles away in Minneapolis. Louis Wilson, a pathologist the Mayo brothers had hired in 1905, championed a more rigorous system of specialty training. An educational reformer, Wilson focused on the need to improve postgraduate training at a time when the emphasis in the United States was on closing or reforming substandard medical schools. The fellowship program established in Rochester, Minnesota, was unique in that it required candidates to have graduated from an acceptable medical school and to have completed an internship. Mayo fellows spent three years preparing for careers as medical or surgical specialists. Fear of competition led several physicians in the Twin Cities to attempt to end the affiliation between the Mayo Foundation and the University of Minnesota. Their efforts failed.

scholarly journals Developing a Respiratory Depression Scorecard for Capnography Monitoring

2013 ◽  
Vol 4 (3) ◽  
Author(s):  
Katie Felhofer
Keyword(s):  
Risk Factors ◽  
Pulse Oximetry ◽  
Respiratory Depression ◽  
Chart Review ◽  
Medical Center ◽  
Hospital Setting ◽  
Retrospective Chart Review ◽  
University Of Minnesota ◽  
Average Patient ◽  
The University

Pulse oximetry is the most common way to measure a patient's respiratory status in the hospital setting; however, capnography monitoring is a more accurate and sensitive technique which can more comprehensively measure respiratory function. Due to the limited number of capnography monitoring equipment at the University of Minnesota Medical Center-Fairview (UMMC-Fairview), we analyzed which patients should preferentially be chosen for capnography monitoring over pulse oximetry based on risk of respiratory depression. We conducted a retrospective chart review of all serious opioid-induced over-sedation events that occurred at UMMCFairview between January 1, 2008 and June 30, 2012. Thirteen risk factors were identified which predispose patients to respiratory depression. The average patient demonstrated 3.75 risk factors. The most commonly occurring risk factor was the concomitant use of multiple opioids or an opioid and a CNS-active sedative, followed by an ASA score 䊫 3. Based on this data, we developed a scorecard for choosing patients at the most risk of developing respiratory depression; these patients are the best candidates for capnography. Although further studies are necessary to corroborate this research, at this time giving extra consideration to patients demonstrating the previously stated risk factors is prudent when assessing those patients most in need of capnography.   Type: Student Project

Spectrum of Antiphospholipid Antibodies and Associated Thrombotic and Obstetric Events among Patients with Antiphospholipid Syndrome

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5343-5343
Author(s):  
Mrinal M Patnaik ◽  
Kitsada Wudhikarn ◽  
Monal M Shroff ◽  
Anthony A Killeen ◽  
Mark T. Reding ◽  
...  
Keyword(s):  
Antiphospholipid Antibodies ◽  
Recurrent Events ◽  
Medical Center ◽  
Anticardiolipin Antibodies ◽  
Obstetric Outcomes ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
University Of Minnesota ◽  
Initial Event ◽  
The University

Abstract Introduction: Antiphospholipid antibody syndrome (APS) is characterized by arterial or venous thrombosis, and/or adverse obstetric outcomes in the presence of persistent antiphospholipid antibodies (APab). Between 2–10% of all patients with APS are reported to present solely with anti beta-2 glycoprotein 1 antibodies (b2GP1 abs) (ref 1). In 2006 the Sapporo criteria were revised to include b2GP1 abs to the panel of diagnostic tests. While presence of a lupus anticoagulant (LA) has been found to correlate well with occurrence of thromboses, the prognostic and predictive roles of b2GP1 abs and anticardiolipin antibodies (ACLA) need better definition. Previous studies suggest both the severity of the initial event and the risk for recurrent events is greater among patients demonstrating presence of more than one APab on laboratory testing (ref 2 and 3), but this aspect needs further confirmation. Objectives: To identify the spectrum of clinical thrombotic and obstetric manifestations associated with the different APab profiles; To determine the prevalence and clinical significance of the b2GP1 ab positive and ACLA/LA negative phenotype; and To evaluate the significance of IgM b2GP1 ab and IgM ACLA. Methods: Medical records of patients tested for all three antiphospholipid antibodies at the University of Minnesota Medical Center from Dec 2000 to Dec 2005 were reviewed. Patients that met the modified criteria for APS were included. IgG and IgM ACLA were measured using the Diamedix kit (VAX diagnostics) and IgG and IgM b2GP1 abs using the Inovalite kit (NOVA diagnostics). LA was determined using standard protocol. Results: Over the 5 year period, all three laboratory assays were obtained in 560 individuals, but only 76 (13.5%) patients who met both the clinical and laboratory criteria for APS were included in this study. Seven of the 76 patients (9.2%) had isolated, persistently positive b2GP1 abs. LA alone was present in 21 patients (27.6%). Twenty nine patients (38%) had all three APabs, and had a higher incidence of thrombosis at multiple sites at the time of diagnosis as well as increased rate of recurrent events, in comparison to those with two or less than two APab. Isolated ACLA was present in only 2 patients (2.6%). Interestingly, both IgM (47%) and IgG (50%) b2GP1 abs were associated with thrombosis, whereas only IgG ACLA was found to be associated with thrombosis. Conclusion: The presence of b2GP1 abs as the sole laboratory anomaly is uncommon, but is noted in patients with APS, thus warranting it’s testing at the time of clinical suspicion. Amongst the different antibody types LA seems to be the strongest predictor for thrombotic events and ACLA seems to have a weaker link, consistent with the results of previous studies (ref 4). The presence of all three AP antibodies does increase the risk for recurrent and multiple thromboses.

scholarly journals P818 Venous thromboembolism is rare among hospitalised patients with an inflammatory bowel disease flare: a multicentre retrospective cross-sectional study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S636-S637
Author(s):  
T Khoury ◽  
A Shafrir ◽  
I Kalisky ◽  
M Safadi ◽  
A Mari ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Venous Thromboembolism ◽  
Bowel Disease ◽  
Medical Center ◽  
Cross Sectional ◽  
Disease Flare ◽  
Line Insertion ◽  
Inflammatory Bowel ◽  
The Mean ◽  
Picc Line

Abstract Background Inflammatory bowel disease (IBD) patients have twice the risk of venous thromboembolism (VTE) compared with healthy controls. VTE can occur at both hospitalisation and after discharge. We aimed to assess the prevalence of VTE among IBD patients who were hospitalised with disease flare at three Israeli Hospitals. Methods A retrospective cross-sectional analysis including all IBD patients who were admitted with disease flare at Galilee Medical Center, EMMS Nazareth Hospital and Hadassah Medical Center. Exclusion criteria were patients with confirmed diagnosis of hypercoagulable state or patients on drugs with pro-coagulable potential. Results Eighty-one patients with overall 114 admissions were included in the study. The average age was 42.2 ± 18.5 years. Sixty-six patients (57.9%) were males. Forty-five admissions (39.5%) were due to ulcerative colitis (UC) flare and 69 admissions (60.5%) were secondary to Crohn’s disease (CD) flare. Twenty-eight patients (24.6%) were smokers. Twenty-five patients (21.9%) and 39 patients (34.2%) were on recent biological and steroid treatment (within 3 months). The mean C-reactive protein and albumin levels at the day of discharge were 4.2 ± 4.6 mg/dl (normal range 0–0.5) and 3.5 ± 0.7 g/dl (normal values above 3.2), respectively. During hospitalisation, 57 (50%), 55 (48.2%), 29 (25.4%), 19 (16.7%) and 8 (7%) patients were treated with intravenous steroids, antibiotics, amino-salicylates, surgery and immunomodulators, respectively. Only four patients (3.5 %) were on prophylactic subcutaneous anticoagulation (enoxaparin) throughout their hospital stay and only 1 patient (0.9%) who have not been on anticoagulation developed in-hospital symptomatic VTE episode. Notably, this patient suffering from CD with ileo-colonic involvement developed subclavian vein thrombosis two day after PICC line insertion for total parenteral nutrition to optimise his nutritional state before performing surgery. The mean hospitalisation length was 6.5 ± 6.6 days. Conclusion In-hospital VTE was rare among our IBD patients admitted with disease flare. In fact, the only one VTE event reported in our cohort is probably related to the PICC line insertion and not related to IBD flare. Notably undergoing surgery in our cohort was not correlated with VTE episodes. Further studies are warranted to characterise IBD patients at risk for VTE, to assess the risk factors for in-hospital VTE development and to address further the role of prophylactic anticoagulation among hospitalised IBD patients, mainly those with bloody diarrhoea.

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