Peripheral access devices

Blood Access Devices. An investigational device called the Osteoport system allows repeated access to the vascular system via an iatraosseous iafusion directiy iato the bone marrow. The port is implanted subcutaneously and secured iato a bone, such as the iUac crest. Medications are adrninistered as ia any conventional port, but are taken up by the venous sinusoids ia the marrow cavity, and from there enter the peripheral circulation (8). 

JM is a 32-year-old woman who was recently diagnosed with stage IIIB Hodgkin s disease. She comes to the clinic to receive her first dose of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy. She currently does not have a central access device therefore, she will receive her chemotherapy via peripheral vein. 

Correct folder/directory structure created and files installed within folders/directories Software configuration completed satisfactorily Site and system identification User access groups Security configuration Menu/display access configuration Logical device connections Inspection of critical hardware components Servers in correct locations Processor speed Cache size ROM bios Memory capacity Peripherals Storage devices Input devices... 

Vascular access devices are classified in peripheral and central venous access devices. Central veins are located in the trunk and neck and are larger in the diameter than peripheral veins. Figure 13.5 shows the diameter of different large vessels. 

The tube consists of synthetic polymers such as fluotinated ethylene propylene (FEP) or polyurethane (PU). For infusion of viscous fluids such as blood and for rapid infusimi cannulas with diameters of 14—16 G have to be used. Smaller size diameters (18—24 G) of catheters are suitable for continuous and intermittent administration of parenteral solutions. Thorough management of the device (e.g. flushing, dressing, daily inspection) reduces complications (e.g. phlebitis) caused by a peripheral access. The need to replace the cannulas routinely is debated. 

Central venous access device Non-tunelled CVC Tunelled CVC PICC Apheresis/ haemodialysis catheter Implantable Port Peripheral venous access device Cannula Midline catheter... 

Long-term central venous access devices used for chemotherapy can be categorized into peripherally inserted central catheters (PlCCs), chest wall external catheters (tunneled and non-tunneled), and subcutaneous ports (chest wall and extremity). 

Many different types of venous-access devices are available. Peripherally inserted central venous catheters (PICCs), which can be made of PU or silicone, are inserted into a vein in the arm rather than in the neck or chest. Nontunneled CVCs are shortterm catheters, made of PU or silicone as well, inserted into the internal jugular, subclavian, or femoral vein. Tunneled CVCs are long-term catheters implanted surgically under the skin. One end of the catheter remains outside the skin and the exit site is typically located in the chest. Passing the catheter under the skin helps to reduce the infection risk and provides stability. Implantable ports are similar to tunneled catheters but are left completely under the skin. They consist in small devices, made of plastic or titanium, inserted beneath the skin and connected to a catheter allowing vascular access. Under the skin, the port has a septum through which drugs can be injected and blood samples can be withdrawn. 

In patients with CKD, preservation of the integrity of peripheral and central veins is of vital importance for future hemodialysis access. Avoid i.v. infusion or vein puncture in the forearm and upper arm veins at both arms whenever possible. Insertion of venous access devices carries the risk to injure the veins and thereby incite phlebitis, sclerosis, stenosis or thrombosis and has to be avoided. Whenever a central venous catheter is needed, catheterization of the internal jugular or femoral vein is always preferred. Use of subclavian vein should be... 

Peripheral data storage devices have to satisfy the requirement of fast access time with the capacity to store a sufficient volume of data. Magnetic tape systems are normally used although considerable time saving can be achieved with disc units. Software programmes are initially loaded into their storage facility from prepared paper or magnetic tape. 

The main characteristic of Software Implemented Fault Injection (SWIFI) is the capacity of injecting previously defined faults in any software accessible functional unit, like memories, registers, peripheral devices, etc. The objective of the injection is the detection of functional errors cansed by faults in HW or systematic errors in SW design. 

Catheter device selection is based on a number of factors, including the plarmed application and placement site, duration of implantation, composition of fluids infused, and frequency of access (Namyslowski and Patel, 1999). Vascular catheters can be divided into two genei groups shortterm, temporary catheters that are placed percutaneously, and long-term, indwelling vascular catheters that usually require a surgical insertion. Temporary catheters include short peripheral venous and arterial catheters, nontunneled central venous and arterial catheters, and peripherally inserted central catheters (Pearson, 1996). Tunneled central venous catheters and totally implantable intra-... 

Sufficient peripheral devices such as terminals, plotters, and printers are available to use the LIMS. This should ensure that there would be no complaints by users being unable to access the system. 

A peripheral venous catheter or indwelling venous cannula (see Fig. 13.7) is the most commonly used vascular access. Often these infusion devices are named by their brand name such as Venflon marketed by BD or Brauniile marketed by B.Braun Melsungen. The cannula or peripheral venous catheter is inserted into a peripheral vein at the hand or the arm to administer infusion solutions... 

Sandhu J (1998a) Peripheral devices. W. B. Saunders Co. Sandhu J (1998b) Techniques for conventional access to central veins, W. B. Saunders Co... 

I/O modules The I/O modules are composed of the I/O interface unit and the peripheral(s). From the user s view, the I/O modules receive all the instructions and data from the computer user. From the processor point of view, the I/O module is analogous to the memory component in that it will be accessed at a specific address and information can be read/written to it. The I/O modules are an intermediary between the processor and I/O devices to off load some of the processor overhead. However, it is different from memory in that it may send control signals to the processor that will cause a processor exception to occur. Many computer manufacturers use the term exception to include interrupts, and the two terms will be synonymously used throughout this article. Examples of I/O devices are keyboards, printers, disk drives, CD-ROM drives, DVD drives, tape drives, and ZIP drives. 

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