Vascular access is an important component of health care but is not without associated risks, some of which can be life-threatening. The Vessel Health and Preservation (VHP) framework was developed with the intention of providing frontline staff with a resource to assist in assessing and selecting the best vascular access device to meet individual patient needs and to preserve veins for future use. This article examines the impact of the introduction of the framework into a haematology ward in an acute hospital in the North West of England during a 3-month pilot study. The results indicate that the VHP framework gave nursing staff more autonomy to choose the appropriate vascular access device for their patients and improved staff knowledge around pH and osmolality of intravenous drugs. However it is clear that more in-depth evaluations need to be conducted to assess the impact of VHP on patient care and outcomes.

Summary Laryngeal surgery requires a shared airway and close collaboration between surgeon and anaesthetist in order to optimise operating conditions. Apnoeic oxygenation uses the principle of aventilatory mass flow to maintain oxygenation of pulmonary capillary blood under apnoeic conditions while minimising laryngeal movement. Concerns regarding accumulation of carbon dioxide and resultant acidaemia have limited the use of the technique. We performed a prospective study of low‐flow apnoeic oxygenation for patients undergoing microlaryngoscopy under general anaesthesia in order to evaluate the ability of the technique to maintain oxygenation and determine the resultant rate of carbon dioxide accumulation. Sixty‐four patients undergoing microlaryngoscopy under general anaesthesia were studied between November 2016 and December 2018. Intra‐operative oxygenation was provided via a 10‐French oxygen catheter placed into the trachea delivering oxygen at 0.5–1.0 l.min−1. Data regarding apnoea time, peripheral oxygen saturation and venous blood gas concentrations were recorded. The mean (SD) duration of apnoea was 18.7 (7.2) min. Apnoeic oxygenation allowed successful completion of the surgical procedure in 62/64 patients. Mean (SD) rate of rise of the venous partial pressure of carbon dioxide was 0.15 (0.10) kPa.min−1. Operating conditions were recorded qualitatively as being adequate in all cases. No adverse effects were reported. Low‐flow intra‐tracheal apnoeic oxygenation is a simple, effective and inexpensive technique to maintain oxygenation for laryngeal surgery.

Since the introduction of sutureless securement products for vascular access devices (VADs), there has been a great deal of discussion of their advantages and disadvantages in comparison with sutures. This includes questions related to VAD securement, patients' comfort, infection control, user-friendliness and potential complications of using the device. The literature review of the available evidence indicates the superiority of the novel sutureless devices in the aforementioned aspects. The authors collected data to further contribute in the analysis of the attributes of these products, namely Statlock™ and Grip-Lok™ (current devices). The authors then trialled, collected and analysed data from relevant healthcare practitioners on their perception of a novel sutureless 3M™ Tegaderm™ PICC/CVC Securement Device + Tegaderm™ I.V. Advanced Securement Dressing (trialled device) for midline VADs. Evaluation forms have been provided and filled in by the practitioners. The results showed that the trialled product is perceived as user-and patient-friendly, resulting in increased security of VAD and easier handling compared to the current devices. Overall, 70% of the evaluators stated that the trialled product has better or much better overall performance. The remaining 30% characterised the overall performance comparable with the current devices.