SSC 2026 Guidelines now available — 129 adult & 61 pediatric recommendations View guidelines →
An evidence-based clinical reference by Intracav
Evidence-based clinical guidelines and policies for vascular access teams
Evidence-graded
Levels 1a–5, cited to source
Authored by clinicians
Named authors, real credentials
Continuously updated
Last updated Jun 2026
Freely accessible
Open access, no paywall
The latest revisions across every specialty
Step-by-step sterile procedure for changing a central venous catheter or PICC dressing: frequency, CHG antisepsis, transparent vs gauze dressings, securement, MARSI prevention, and documentation.
Step-by-step clinical procedure for removing a central venous catheter and tunneled catheters: Trendelenburg positioning, air-embolism prevention, Valsalva, hemostasis, tip culture, and site-specific considerations.
How ECG-guided (intracavitary ECG) PICC placement works: the P-wave method for real-time tip confirmation at the cavoatrial junction, electrode setup, interpretation, limitations, and when a chest X-ray is still needed.
Complete Groshong catheter guide: the pressure-sensitive three-way valve, why it is locked with saline only, indications, care and maintenance, complications, and how it compares to Hickman and Broviac catheters.
Step-by-step clinical procedure for accessing an implanted port (port-a-cath): site assessment, non-coring needle selection, sterile technique, blood return confirmation, flushing, dressing, and deaccessing.
Step-by-step clinical procedure for safe PICC line removal: positioning, controlled withdrawal, air-embolism and resistance precautions, catheter tip measurement, hemostasis, and documentation.
Analysis, perspectives, and healthcare innovation
This article examines how elevated cortisol levels—the body's primary stress hormone—affect hospital staff's health and work performance. It explains that healthcare workers face unique stressors such as high-stakes patient care, excessive workloads, and lack of institutional support, which can lead to chronically elevated cortisol and subsequent health issues including anxiety, depression, cognitive impairment, and cardiovascular problems. These effects ultimately reduce work efficiency and can compromise patient safety. The article reviews research on cortisol patterns in emergency care providers, discusses how the COVID-19 pandemic exacerbated these challenges, and offers strategies for managing cortisol levels through lifestyle modifications (exercise, sleep hygiene), stress management techniques (mindfulness, CBT), organizational changes (workload management, flexibility), and when necessary, medical interventions. It concludes by urging healthcare organizations to prioritize staff well-being through transparent, supportive management practices to maintain both employee health and quality patient care.
Clinical guidelines as static PDFs are failing healthcare. Learn why API-first medical knowledge distribution is essential for modern clinical decision support and how open-source approaches can revolutionize healthcare interoperability.
Why IntracavOS moved from cloud APIs to a fully isolated, self-hosted AI system: exploring the security philosophy behind closed-loop healthcare AI and the paranoid approach to patient data protection.
A candid critique of healthcare's resistance to innovation: why vascular access and clinical practice remain stuck in outdated patterns while real problems like CLABSIs persist.
Why we built IntracavOS on NixOS: A reproducible, secure, and scalable operating system designed specifically for healthcare AI deployment. Learn about our architecture and why traditional approaches fail.