Arch Surg Chicago
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Comparative Study
Effect of patient position on size and location of the subclavian vein for percutaneous puncture.
Large-bore subclavian intravenous access is important during trauma resuscitation and to provide central access in the intensive care unit. Controversy exists as to the patient position that best facilitates the insertion of this line. Duplex scanning of the subclavian vein in different body positions may help define which provides the largest vein size and distance from the clavicle. ⋯ These data demonstrate that arching of the shoulders and turning of the head may reduce target size and provide an unsatisfactory position for subclavian puncture. The Trendelenburg position with no other positioning maneuvers may be helpful.
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Comparative Study
Comparative outcomes analysis of procedures performed in physician offices and ambulatory surgery centers.
This study compared outcomes to determine whether patient safety is similar in Florida ambulatory surgery centers and offices. ⋯ In this review of surgical procedures performed in offices and ambulatory surgery centers in Florida during a recent 2-year period, there was an approximately 10-fold increased risk of adverse incidents and death in the office setting. If all office procedures had been performed in ambulatory surgery centers, approximately 43 injuries and 6 deaths per year could have been prevented.