SummarySafe vascular access is integral to anaesthetic and critical care practice, but procedures are a frequent source of patient adverse events. Ensuring safe and effective approaches to vascular catheter insertion should be a priority for all practitioners. New technology such as ultrasound and other imaging has increased the number of tools available. This guidance was created using review of current practice and literature, as well as expert opinion. The result is a consensus document which provides practical advice on the safe insertion and removal of vascular access devices.

In this large analysis of US-guided central venous access in a complex patient group, the majority of patients were cannulated successfully and safely. The subset of patients undergoing AxV cannulation demonstrated a low rate of complications. The AxV route of access appears to be a safe and effective alternative to the IJV.

Data from this study support the continued use of anticoagulant agents among routine users during cataract surgery using a sub-Tenon's block.

SummaryThe ability of face masks to prevent forward dispersal of bacteria is offset by the possibility that they may increase vertical shedding of bacteria from the face during facial movement. To investigate this, a blood agar plate was placed 30 cm directly below the lips of 20 volunteers who were encouraged to talk for 20 min while moving their heads from side to side, without a face mask for the first 5 min and then with a standard, soft pleated face mask for the subsequent 15 min. The agar plates were changed at 5-min intervals. Analysis of the number of bacterial colonies grown on each agar plate showed a statistically significant reduction in the median number of colonies cultured per plate when the mask was worn. Our results suggest that for procedures lasting less than 15 min, the operator should wear a face mask, particularly when the face is in close proximity to the operative field and the need for speaking is anticipated.

No abstract