For Clinicians

Point-of-care protocols and clinical decision support for vascular access professionals. Evidence-based guidance when you need it most.

Surgery & Trauma Clinical Guidelines

The surgery and trauma guideline index: ATLS 11, ACS trauma standards, TQP and EAST guidelines, WSES, severe TBI, SSI prevention, intra-abdominal infection.

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Surgery & Trauma

The surgery and trauma department hub, indexing the governing guidelines: ATLS 11, ACS trauma standards, TQP, EAST, WSES, severe TBI, SSI prevention, and ERAS.

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Perioperative & Anesthesia Clinical Guidelines

Perioperative and anesthesia guideline index: the governing ASA, ERAS, ACC/AHA, ASRA, and Association of Anaesthetists guidelines, with edition and source.

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Perioperative & Anesthesia

The perioperative and anesthesia hub. Indexes the governing ASA, ERAS, ACC/AHA, ASRA, and Association of Anaesthetists guidelines, each with a source link.

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Pediatrics & Neonatal Clinical Guidelines

Pediatrics and neonatal guidelines index: AAP clinical practice guidelines, AHA/AAP resuscitation, SSC pediatric sepsis, and IDSA/PIDS pneumonia, with sources.

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Pediatrics & Neonatal

The pediatrics and neonatal hub: governing AAP clinical practice guidelines, AHA/AAP resuscitation, SSC pediatric sepsis, and IDSA/PIDS pneumonia, with sources.

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Obstetrics & Maternal Care Clinical Guidelines

Obstetrics and maternal care guidelines index: ACOG bulletins and clinical practice guidelines, SMFM, AIM safety bundles, WHO, and AWHONN, with sources.

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Obstetrics & Maternal Care

The obstetrics and maternal care hub: governing ACOG bulletins and clinical practice guidelines, SMFM, AIM safety bundles, WHO, and AWHONN, each with source.

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Neurology & Stroke Clinical Guidelines

Neurology and stroke guidelines index: AHA/ASA, Neurocritical Care Society, AES, ILAE, AAN, and Brain Trauma Foundation guidelines with edition and source.

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Neurology & Stroke

The neurology and stroke hub: governing AHA/ASA, Neurocritical Care Society, AES, ILAE, AAN, and Brain Trauma Foundation guidelines, with edition and source.

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Nephrology & Dialysis Clinical Guidelines

Nephrology and dialysis guideline index: the governing KDIGO and KDOQI guidelines on CKD, AKI, glomerular disease, anemia, and dialysis, with source links.

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Nephrology & Dialysis

The nephrology and dialysis hub. Indexes the governing KDIGO and KDOQI guidelines on CKD, AKI, glomerular disease, anemia, CKD-MBD, and dialysis, with sources.

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Hospital Medicine Clinical Guidelines

The hospital medicine guideline index: governing society guidelines for adult inpatient care, from CAP and C. difficile through VTE, PE, glycemia, and Beers.

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Hospital Medicine

The hospital medicine department hub, indexing the governing society guidelines for adult inpatient care: pneumonia, C. difficile, UTI, VTE, PE, and glycemia.

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Clinical Pharmacy Clinical Guidelines

The clinical pharmacy guideline index: governing guidelines and standards for hospital medication use, from stewardship and vancomycin to USP 797 and ISMP.

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Clinical Pharmacy

The clinical pharmacy department hub, indexing the governing guidelines for hospital medication use: stewardship, vancomycin, medication safety, USP 797, Beers.

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Cardiology Clinical Guidelines

Cardiology guideline index: the governing ACC/AHA, ESC, HRS, and AHA guidelines on heart failure, coronary disease, atrial fibrillation, and resuscitation.

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Cardiology

The cardiology hub. Indexes the governing ACC/AHA, ESC, HRS, and AHA guidelines on heart failure, coronary disease, atrial fibrillation, and resuscitation.

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Mike Stern, MD

Mike Stern, MD — Chief Executive Officer of Intracav. Trauma surgeon, ICU director, and vascular access medical director; co-founder of Intracav and The Clinical Database.

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Isaiah Wright

Isaiah Wright — Chief Technology Officer of Intracav. Software engineer focused on clinical AI infrastructure; built systems for the Department of Homeland Security; co-founder of Intracav and The Clinical Database.

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Dennis Woo, RN

Dennis Woo, RN — Chief Medical Officer of Intracav. Interventional Vascular Access Specialist RN with experience in pediatric and adult emergency nursing; co-founder of Intracav and The Clinical Database.

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Authors & Editorial Team

The clinicians and engineers who write and review The Clinical Database — Mike Stern, MD; Dennis Woo, RN; and Isaiah Wright.

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Vascular Access Devices Compared: PIV, Midline, PICC, CVC, Port, and More

A complete side-by-side comparison of every vascular access device — peripheral IV, midline, PICC, non-tunneled CVC, tunneled catheter, implanted port, dialysis catheter, arterial line, and IO — by tip location, dwell, indications, and limits.

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PICC vs Midline: Differences, Indications, and How to Choose

PICC vs midline: the clinical differences, indications, contraindications, and a decision framework for choosing between a midline catheter and a PICC line — by infusate, duration, and patient factors.

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PICC Line Removal: Step-by-Step Clinical Procedure

Step-by-step clinical procedure for safe PICC line removal: positioning, controlled withdrawal, air-embolism and resistance precautions, catheter tip measurement, hemostasis, and documentation.

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Midline Catheters: The Complete Clinical Reference

The complete clinical reference on midline catheters: indications, contraindications, ultrasound-guided insertion, maintenance, dwell time, complications, removal, and midline-vs-PICC device selection — evidence-based.

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ECG-Guided PICC Placement: Tip Confirmation Technique

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.

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Central Line & PICC Dressing Change: Step-by-Step Procedure

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.

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Vascular Access Glossary: Terms, Abbreviations & Definitions

A clinician-reviewed glossary of vascular access terms and abbreviations — VAD, CVAD, PICC, CLABSI, DIVA, VHP, vesicant, fibrin sheath, MARSI, and more — with concise, evidence-based definitions.

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Vascular Access AI: How Clinical AI Supports Device Decisions

How artificial intelligence supports vascular access — evidence retrieval, device-selection decision support, and guideline-grounded answers — and where the clinical AI for vascular access lives.

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Surviving Sepsis Campaign: International Guidelines for the Management of Sepsis and Septic Shock in Children 2026

Complete clinical reference for the 2026 Surviving Sepsis Campaign pediatric guidelines — 61 evidence-based recommendations covering recognition, antimicrobial therapy, fluid therapy, hemodynamic management, vasoactive medications, ventilation, corticosteroids, metabolic management, blood products, renal replacement therapy, ECMO, immune therapies, long-term follow-up, and prophylaxis in pediatric sepsis and septic shock.

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SSC 2026 — Part 6: Goals of Care, Transitions & Long-Term Outcomes

Surviving Sepsis Campaign 2026 recommendations for goals of care discussions, advanced directives, time-limited trials, palliative care, ICU transition programs, handoff processes, medication reconciliation, discharge planning, patient and family education, post-critical illness follow-up, physical rehabilitation, mental health support, and cognitive recovery in adult sepsis and septic shock.

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SSC Children 2026 — Part 5: Long-Term Follow-Up & Prophylaxis

Surviving Sepsis Campaign 2026 pediatric recommendations for immune stimulants in immunoparalysis, immunosuppressive therapy for hyperferritinemia, early rehabilitation bundles, targeted posthospital follow-up, post-sepsis morbidity screening, stress ulcer prophylaxis, VTE prophylaxis, nutrition, and blood products in children with sepsis.

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SSC 2026 — Part 5: Adjunctive & Supportive Therapies

Surviving Sepsis Campaign 2026 recommendations for IV corticosteroids, antipyretic therapy, IV vitamin C, IV immunoglobulins, blood purification, polymyxin B hemoperfusion, vitamin D, XueBiJing, stress ulcer prophylaxis, probiotics, active fluid removal, restrictive transfusion, enteral nutrition, insulin therapy, renal replacement therapy, sodium bicarbonate, and VTE prophylaxis in adult sepsis and septic shock.

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SSC Children 2026 — Part 4: Corticosteroids, Metabolic & Adjunctive Therapies

Surviving Sepsis Campaign 2026 pediatric recommendations for hydrocortisone, fever management, sodium bicarbonate, calcium, levothyroxine, vitamin C, thiamine, vitamin D, fluid balance, high-volume hemofiltration, plasma exchange for TAMOF, extracorporeal blood purification, ECMO, immunosuppressive therapy management, and IVIG in pediatric sepsis.

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SSC 2026 — Part 4: Respiratory Support

Surviving Sepsis Campaign 2026 recommendations for oxygenation monitoring, oxygen targets, high flow nasal cannula, noninvasive positive pressure ventilation, awake proning, lung-protective ventilation, tidal volumes, plateau pressure limits, PEEP strategy, prone ventilation, neuromuscular blockade, and veno-venous ECMO in adult sepsis and septic shock.

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SSC Children 2026 — Part 3: Vasoactive Medications & Ventilation

Surviving Sepsis Campaign 2026 pediatric recommendations for vasoactive medication timing, epinephrine vs norepinephrine, peripheral vasoactive initiation, vasopressin, inodilators, angiotensin II, methylene blue, intubation in septic shock, etomidate avoidance, and conservative SpO2 targets in children.

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SSC 2026 — Part 3: Hemodynamic Management

Surviving Sepsis Campaign 2026 recommendations for blood pressure monitoring, fluid type selection, balanced crystalloids, albumin, liberal vs restrictive fluid strategies, dynamic measures for fluid responsiveness, cardiac output monitoring, serial lactate, capillary refill time, vasopressor hierarchy, inotropes, methylene blue, midodrine, and beta-blockers in adult sepsis and septic shock.

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SSC Children 2026 — Part 2: Source Control, Fluid Therapy & Hemodynamic Management

Surviving Sepsis Campaign 2026 pediatric recommendations for emergent source control, intravascular device removal, fluid bolus therapy in septic shock, fluid therapy in non-ICU settings, balanced crystalloids vs saline, hemodynamic assessment, ScvO2 targeting, advanced monitoring, and point-of-care ultrasound in pediatric sepsis.

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SSC 2026 — Part 2: Infection — Antimicrobial Therapy & Source Control

Surviving Sepsis Campaign 2026 recommendations for antimicrobial timing by diagnostic certainty, prehospital antibiotics, source control, empiric MDR and antifungal coverage, anaerobic coverage, rapid diagnostics, prolonged beta-lactam infusion, therapeutic drug monitoring, de-escalation, procalcitonin-guided discontinuation, and selective decontamination of the digestive tract.

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SSC Children 2026 — Part 1: Recognition, Screening & Antimicrobial Therapy

Surviving Sepsis Campaign 2026 pediatric recommendations for sepsis screening, performance improvement programs, blood lactate, blood cultures, molecular testing, antimicrobial timing, empiric broad-spectrum therapy, beta-lactam infusion strategies, de-escalation, procalcitonin-guided therapy, and infectious diseases consultation in children.

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SSC 2026 — Part 1: Screening & Early Management

Surviving Sepsis Campaign 2026 recommendations for performance improvement programs, code sepsis protocols, prehospital and in-hospital screening, biomarkers, blood cultures, lactate measurement, initial fluid resuscitation, vasopressor timing, peripheral vasopressor initiation, MAP targets, and ICU admission.

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Interactive Education

Interactive educational series for clinicians — explore the mathematics, physics, and decision science behind clinical procedures through hands-on simulations and visualizations.

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Infection Prevention Guidelines

Evidence-based guidelines for infection prevention practice — methodology, implementation, and quality standards.

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Infection Prevention

The cross-department infection prevention hub — CLABSI prevention (program-level and ICU-level), ventilator-associated pneumonia, hand hygiene, ANTT, precautions, skin antisepsis, and the guideline development handbook, indexed in one place.

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ICU Clinical Guidelines

Comprehensive, evidence-based clinical guidelines for intensive care practice — synthesized from multiple professional society recommendations covering sepsis, ventilation, sedation, infection prevention, nutrition, hemostasis, renal support, post-arrest care, and transfusion medicine.

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Emergency Medicine

The emergency medicine department hub — ten multi-society clinical guideline series covering cardiac arrest, ACS, stroke, trauma, TBI, airway and RSI, pain and sedation, toxicology, abdominal emergencies, and pediatrics, each broken into linked part pages.

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Emergency Department Clinical Guidelines

Comprehensive, evidence-based clinical guidelines for emergency medicine practice — synthesized from multiple professional society recommendations covering cardiac emergencies, stroke, trauma, toxicology, airway management, pediatrics, and procedural care.

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Critical Care

The critical care department hub — twelve multi-society clinical guideline series covering sepsis (including SSC 2026 adult and pediatric), mechanical ventilation and ARDS, VAP, CLABSI prevention, PADIS, nutrition, VTE prophylaxis, transfusion, AKI/RRT, and post-arrest care, each broken into linked part pages.

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Acute Stroke Management: A Comprehensive Emergency Guideline

Evidence-based guideline for recognition, evaluation, thrombolysis, thrombectomy, and management of ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage in the emergency department.

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Trauma Primary and Secondary Survey — Part 5: Special Trauma Populations

Pediatric trauma (vital signs by age, Broselow, non-accidental trauma), geriatric trauma (anticoagulant reversal, occult shock), pregnant trauma (physiologic changes, perimortem C-section), burns (Parkland formula, rule of nines, escharotomy), and penetrating vs blunt selective non-operative management.

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Pediatric Emergencies — Part 5: Common Surgical Emergencies, Trauma & Neonatal Emergencies

Intussusception, pyloric stenosis, testicular torsion, PECARN head CT and abdominal trauma decision rules, solid organ injury non-operative management, non-accidental trauma screening, neonatal emergencies including hypoglycemia, congenital heart disease with PGE1, hyperbilirubinemia, and a comprehensive pediatric medication dosing reference table.

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Part 5: Specific Etiologies, Special Populations, and Quality Metrics

COVID-19 ARDS phenotypes and management, transfusion-related acute lung injury, aspiration-related ARDS, immunocompromised patients, obesity and ARDS, pediatric considerations, long-term outcomes, and ICU quality benchmarks for ventilator management.

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Part 5: Special Populations & Quality Metrics

PADIS management in special populations including post-operative, neurological injury, substance withdrawal (alcohol/CIWA, opioid/COWS), ECMO and CRRT dosing adjustments, plus quality metrics, bundle compliance measurement, and implementation strategies.

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Acute Kidney Injury — Part 5: Special Populations & Long-Term Outcomes

Sepsis-associated AKI, cardiac surgery-associated AKI, contrast-associated AKI, hepatorenal syndrome, rhabdomyolysis, tumor lysis syndrome, AKI in pregnancy, long-term outcomes, CKD progression, nephrology referral criteria, and quality metrics.

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Ventilator-Associated Pneumonia — Part 4: Specific Pathogens, Surveillance & Quality Metrics

Pathogen-directed therapy for MRSA, Pseudomonas aeruginosa, Acinetobacter baumannii, ESBL-producing Enterobacterales, and Stenotrophomonas maltophilia with dosing tables, VAE versus traditional VAP surveillance reporting, NHSN definitions and algorithms, quality metrics including VAE rates and bundle compliance, and antibiotic stewardship considerations.

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Trauma Primary and Secondary Survey — Part 4: Focused Injury-Specific Assessment

Head injury assessment, cervical spine clearance (Canadian C-Spine Rule, NEXUS), chest injury evaluation, abdominal assessment with AAST organ injury grading (liver, spleen, kidney), pelvic fracture management, extremity vascular injury and compartment syndrome, and spinal injury with TLICS scoring.

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Toxicology and Overdose Management — Part 4: Toxic Alcohols, Metals, Organophosphates, Environmental & Chemical Poisonings

Complete management of methanol and ethylene glycol poisoning (fomepizole, hemodialysis), carbon monoxide, cyanide, organophosphates and nerve agents, iron poisoning, caustic ingestions, local anesthetic systemic toxicity (LAST), sympathomimetic toxicity, and enhanced elimination techniques including urinary alkalinization and EXTRIP hemodialysis indications.

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Sepsis and Septic Shock — Part 4: Corticosteroids & Organ Support

Corticosteroid indications and evidence in septic shock, mechanical ventilation in sepsis-induced ARDS, renal replacement therapy, blood product management, glucose management, DVT and stress ulcer prophylaxis, and nutrition.

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Pediatric Emergencies — Part 4: Neurologic, Metabolic & Fluid Emergencies

Febrile seizure evaluation, status epilepticus protocol with stepwise treatment, clinical dehydration assessment, WHO dehydration classification, ORT protocol, IV fluid calculation with Holliday-Segar rule, hyponatremia correction, and pediatric diabetic ketoacidosis management including 2-bag system and cerebral edema monitoring.

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Part 4: Non-Invasive Support and Ventilator Liberation

High-flow nasal cannula and FLORALI trial evidence, NIV/BiPAP in ARDS, daily spontaneous breathing trial protocols, SAT-SBT coordination, RSBI, extubation criteria, cuff leak test, post-extubation support, and tracheostomy timing.

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Part 4: Early Mobility and Exercise & Sleep Promotion

Safety screening criteria for ICU mobilization, progressive mobility levels, ICU-acquired weakness diagnosis and prevention, barriers to early mobility, sleep disruption assessment and causes, non-pharmacologic and pharmacologic sleep interventions, and circadian rhythm management.

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Nutrition in Critical Illness — Part 4: Immunonutrition & Special Populations

Comprehensive guide to immunonutrition (arginine, glutamine, omega-3 fatty acids, antioxidants), and nutrition management in special ICU populations including sepsis, burns, trauma, TBI, acute pancreatitis, ECMO, obesity, chronic critical illness, open abdomen, and CRRT.

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Acute Stroke Management — Part 4: Intracerebral Hemorrhage

ICH pathophysiology, ICH Score, hematoma expansion, blood pressure management (INTERACT2, ATACH-2), anticoagulant reversal protocols, surgical intervention criteria (STICH, MISTIE III, ENRICH), and ICP management.

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Ventilator-Associated Pneumonia — Part 3: Diagnosis & Antimicrobial Treatment

Clinical diagnostic criteria, CPIS scoring table, microbiologic sampling strategies (ETA, BAL, mini-BAL) with quantitative thresholds, biomarker guidance, empiric antibiotic selection stratified by MDR risk with complete dosing tables and renal adjustments, de-escalation principles, short-course duration evidence, inhaled antibiotics, and treatment failure evaluation.

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Traumatic Brain Injury — Part 3: ICP Management & Surgical Indications

ICP monitoring indications, ICP and CPP targets, complete tiered ICP management protocol with dosing, hyperosmolar therapy, EVD drainage, decompressive craniectomy (DECRA, RESCUEicp), barbiturate coma, and surgical indications for epidural hematoma, subdural hematoma, depressed skull fracture, and posterior fossa lesions.

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Transfusion in Critical Care — Part 3: Massive Transfusion & Hemorrhage Management

Massive transfusion protocol activation, fixed-ratio transfusion (1:1:1 per PROPPR), TEG/ROTEM viscoelastic testing and interpretation, damage control resuscitation, TXA (CRASH-2), calcium replacement, permissive hypotension, and hemorrhage management in trauma, obstetric, and GI bleeding.

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Pediatric Emergencies — Part 3: Pediatric Sepsis & Febrile Infant Evaluation

Pediatric sepsis recognition with age-specific SIRS criteria, sepsis resuscitation protocol, vasopressor selection, antibiotic guidance, febrile infant risk stratification by age, Rochester-Philadelphia-Boston criteria comparison, PECARN febrile infant rule, and neonatal CSF interpretation.

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Part 3: Delirium Assessment, Prevention, and Management

Complete delirium assessment tools (CAM-ICU flowsheet, ICDSC scoring), delirium subtypes, modifiable and non-modifiable risk factors, evidence-based non-pharmacologic prevention bundles, and pharmacologic management including haloperidol, quetiapine, and dexmedetomidine dosing.

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Part 3: Adjunctive and Rescue Therapies

Recruitment maneuvers and evidence from the ART trial, conservative fluid management from the FACTT trial, inhaled pulmonary vasodilators, ECMO indications and referral criteria from the EOLIA trial, high-frequency oscillatory ventilation, and corticosteroids in ARDS.

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Nutrition in Critical Illness — Part 3: Parenteral Nutrition & Micronutrients

Comprehensive guide to parenteral nutrition in the ICU: indications, timing controversies, composition, lipid emulsions, monitoring, complications, transition to EN, and micronutrient supplementation including thiamine, vitamin C, vitamin D, selenium, zinc, and refeeding syndrome prevention.

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Ventilator-Associated Pneumonia — Part 2: Prevention Bundles & Supplemental Strategies

Comprehensive evidence review of VAP prevention bundle components including head-of-bed elevation, sedation management, oral care and chlorhexidine controversy, subglottic secretion drainage, ETT cuff pressure, suctioning, circuit management, early mobility, stress ulcer prophylaxis, and supplemental strategies including SDD/SOD, silver-coated ETTs, and probiotics.

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Pediatric Emergencies — Part 2: Pediatric Respiratory Emergencies

Croup scoring and management, bronchiolitis evaluation and supportive care, acute asthma severity classification and stepwise treatment, anaphylaxis recognition and epinephrine dosing, and foreign body aspiration management.

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Part 2: Prone Positioning and Neuromuscular Blockade

Indications, protocols, and evidence for prone positioning in ARDS based on the PROSEVA trial, procedural checklists and contraindications, neuromuscular blockade evidence from ACURASYS and ROSE trials, train-of-four monitoring, and current recommendations.

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Part 2: Insertion Bundle & Maintenance Bundle — CLABSI Prevention in the ICU

Evidence-based insertion bundle components (hand hygiene, maximal sterile barriers, chlorhexidine antisepsis, site selection, daily necessity review) and maintenance bundle components (hub disinfection, CHG bathing, dressing management, needleless connectors, administration set changes) with supporting evidence.

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Part 2: Agitation and Sedation Assessment and Management

Comprehensive sedation assessment (RASS, SAS complete scoring tables), light sedation targets, sedative agent pharmacology and dosing (propofol, dexmedetomidine, midazolam, ketamine), propofol infusion syndrome, daily sedation interruption protocols, and nurse-driven sedation algorithms.

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Nutrition in Critical Illness — Part 2: Enteral Nutrition

Comprehensive guide to enteral nutrition in the critically ill: timing of initiation, gastric vs post-pyloric access, advancement protocols, formula selection, gastric residual volume management, prokinetic agents, complications including aspiration and refeeding syndrome, and EN during prone positioning and vasopressor therapy.

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Acute Stroke Management — Part 2: Intravenous Thrombolysis

Alteplase and tenecteplase dosing, complete inclusion/exclusion criteria for 0-3h and 3-4.5h windows, blood pressure management peri-thrombolysis, orolingual angioedema, and hemorrhagic transformation.

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Acute Airway Management & RSI — Part 2: RSI Protocol & Medications

Complete RSI protocol including preparation, pretreatment agents, induction agents with dosing tables, neuromuscular blocking agents with contraindications and reversal, paralysis verification, post-intubation sedation, confirmation of intubation, awake intubation, and drug-assisted intubation without paralysis.

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Transfusion in Critical Care — Part 1: Red Blood Cell Transfusion

Evidence-based hemoglobin thresholds for RBC transfusion in the critically ill, landmark trial evidence (TRICC, TRISS, FOCUS, TITRe2, TRICS-III), physiologic triggers, single-unit policy, compatibility testing, and storage considerations.

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Part 1: ARDS Definition and Initial Ventilator Setup

Berlin criteria for ARDS severity classification, initial ventilator mode selection, lung-protective tidal volume targets, ideal body weight calculations, plateau and driving pressure limits, ARDSNet PEEP/FiO2 tables, respiratory rate management, and permissive hypercapnia.

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Part 1: ABCDEF Bundle Overview & Pain Assessment and Management

The ABCDEF bundle framework for ICU liberation, comprehensive pain assessment tools (BPS, CPOT, NRS) with complete scoring tables, and evidence-based analgesic management including opioid dosing, non-opioid adjuncts, and multimodal protocols.

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Oncology Clinical Guidelines

Comprehensive, evidence-based clinical guidelines for oncology practice — synthesized from multiple professional society recommendations covering vascular access, supportive care, safety, pain management, immunotherapy, and survivorship.

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Oncology

The oncology department hub — ten multi-society clinical guideline series covering central venous access in cancer patients, extravasation, cancer-associated thrombosis, febrile neutropenia, CINV, mucositis, hazardous drug handling, cancer pain, immunotherapy adverse events, and survivorship.

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CINV Guideline — Part 3: Recommended Antiemetic Regimens and Special Populations

Guideline-recommended antiemetic regimens by emetogenic risk level, multi-day chemotherapy protocols, oral chemotherapy CINV, radiation-induced nausea and vomiting, breakthrough and refractory CINV management, and considerations for pediatric, geriatric, and organ-impaired populations.

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Febrile Neutropenia — Part 2: Empiric Antibiotic Therapy & Outpatient Management

Empiric intravenous antibiotic monotherapy and combination regimens with complete dosing, indications for vancomycin and anti-gram-positive agents, antibiotic de-escalation and duration criteria, outpatient eligibility for low-risk febrile neutropenia, oral antibiotic regimens, and monitoring requirements.

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Vascular Anatomy for Ultrasound-Guided Access: Upper Extremity and Neck

Clinical guide to vascular anatomy for ultrasound-guided vascular access: upper extremity veins (basilic, brachial, cephalic), internal jugular vein, femoral vessels — identification, landmarks, and differentiating vein from artery on ultrasound.

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Vascular Access Teams: Evidence Base and Return on Investment

Evidence-based review of vascular access team (VAT) outcomes: CLABSI reduction, first-attempt success rates, catheter-related complication reduction, cost savings, and return on investment data supporting dedicated vascular access specialist programs.

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Vascular Access Safety: Annual State of the Practice Report

Annual state-of-the-practice safety report for vascular access: national CLABSI rates, PICC complication data, peripheral IV failure rates, phlebitis benchmarks, catheter-related DVT epidemiology, and the current evidence base driving vascular access safety standards.

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Vascular Access Quality Metrics: Key Performance Indicators and Benchmarking

Comprehensive guide to vascular access quality metrics: CLABSI rates and SIR benchmarking, first-attempt success rates, phlebitis rates, catheter utilization ratios, PICC appropriateness tracking, dwell time management, and building a vascular access quality dashboard.

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Vascular Access Knowledge Center

The most comprehensive vascular access knowledge base for clinicians — evidence-based guides on PICC lines, CVCs, CLABSI prevention, complications, ultrasound, credentialing, and infusion therapy.

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Vascular Access in Special Populations: Clinical Reference

Clinical reference for vascular access in special populations: pediatric, NICU/neonatal, oncology, hemodialysis, critical care, geriatric, obese, and immunocompromised patients — device selection, technique modifications, and population-specific risks.

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Vascular Access Fundamentals

Foundational vascular access guides — definitions, the device-type spectrum, evidence-based device selection, documentation requirements, and standards and regulations.

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Vascular Access Documentation: What to Record and When

Complete guide to vascular access documentation requirements: insertion notes, daily assessment, infusion therapy documentation, complication recording, device removal, and EHR best practices.

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Vascular Access Device Competency and Credentialing Checklist

Comprehensive vascular access device (VAD) competency and credentialing checklist covering peripheral IV, midline, PICC, central venous catheter, and implanted port access — including ultrasound guidance competency, bundle compliance verification, and annual maintenance requirements.

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Vascular Access Clinical Resources

Free clinical resources for vascular access professionals: safety reports, CLABSI prevention frameworks, competency checklists, and audit tools — designed for hospital educators and VAT program leaders.

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Vascular Access

The definitive clinical reference on vascular access — the full device spectrum (PICC, CVC, midline, port, PIV), evidence-based device selection, clinical standards, complication prevention, documentation, and quality metrics for clinicians.

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Ultrasound-Guided Vascular Access: Clinical Reference

Complete clinical reference on ultrasound-guided vascular access: evidence base, vascular anatomy, technique (short-axis vs long-axis), US-guided PIV, PICC, and CVC insertion, tip confirmation, and credentialing requirements.

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Ultrasound-Guided PICC Insertion: Complete Procedural Guide

Complete ultrasound-guided PICC insertion guide: pre-insertion vein survey, long-axis technique for basilic vein cannulation, guidewire US confirmation, catheter measurement, and intraoperative tip guidance with ECG.

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PICC Lines: The Complete Clinical Reference

The complete clinical reference on PICC lines: indications, ultrasound-guided insertion, CEVAD tip position standards, maintenance protocols, complications, and removal — evidence-based.

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PICC Line Indications: Who Needs a PICC and When

Clinical indications for PICC line placement — appropriate and inappropriate criteria and MAGIC, PICC for IV antibiotics, chemotherapy, TPN, and vesicants, and absolute contraindications.

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PICC Line Complications: Prevention, Recognition, and Management

Complete guide to PICC line complications: PICC-associated DVT (incidence, prevention, anticoagulation), CLABSI prevention, catheter occlusion (alteplase protocol), phlebitis, mechanical complications, and MARSI prevention.

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Infusion Therapy Safety: Clinical Standards and Best Practices

Complete clinical reference on infusion therapy safety: filtration standards, flushing and locking, vesicant administration, high-alert medications, PN access requirements, administration set management, and smart pump safety.

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Infusion Filtration: Clinical Guide to Filter Selection and Requirements

Complete guide to infusion filtration requirements: 0.2 micron vs 1.2 micron filter selection, medications requiring filtration, medications that cannot be filtered, TPN filtration requirements, and air-eliminating filter standards.

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Implanted Vascular Access Ports: Complete Clinical Guide

Complete clinical guide to implanted vascular access ports: port anatomy, Huber needle access technique, ANTT flushing and locking protocol, power-injectable ports, port complications, and deaccess procedure.

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Hemodialysis Vascular Access: AVF, AVG, and Tunneled Dialysis Catheter Clinical Guide

Clinical guide to hemodialysis vascular access: AVF creation and maturation criteria, AV graft cannulation, tunneled dialysis catheter placement and complications, vessel preservation in CKD/ESRD, fistula-first policy, buttonhole vs rope-ladder technique, and catheter-to-fistula transition.

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Flushing and Locking Vascular Access Devices: SASH Protocol and Evidence

Evidence-based guide to vascular access device flushing and locking: SASH protocol (Saline-Administer-Saline-Heparin), pulsatile flush technique, positive pressure locking, heparin vs saline evidence, flush volumes, and device-specific protocols.

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CVAD Tip Location Standards: CEVAD Consensus and Clinical Application

CVAD tip location standards per CEVAD 2020 consensus: cavoatrial junction target, radiographic landmarks, device-specific tip positions, tip confirmation methods (ECG, CXR, fluoroscopy), and malposition classification.

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CLABSI Prevention: The Complete Evidence-Based Bundle

The complete evidence-based CLABSI prevention guide: CDC/NHSN definitions, insertion bundle, maintenance bundle, CHG bathing, antimicrobial strategies, surveillance, and Zero CLABSI implementation.

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Central Venous Catheters: Types, Indications, and Clinical Safety

Complete clinical reference on central venous catheters: non-tunneled CVCs (IJ, subclavian, femoral), tunneled catheters (Hickman, Broviac, Groshong), implanted ports, dialysis catheters, and CVAD tip location standards.

guide Clinician Central Venous Access

Catheter Occlusion Management: Alteplase, Troubleshooting, and Prevention

Complete clinical guide to catheter occlusion management: occlusion types (thrombotic, non-thrombotic, mechanical), alteplase protocol (2 mg/2 mL), troubleshooting approach, non-thrombotic occlusion management, and prevention with SASH flushing.

guide Clinician Catheter Complications

Catheter Malposition: Recognition, Types, and Management

Guide to CVAD malposition types, recognition, and management: primary malposition (at insertion), secondary malposition (tip migration), IJ, azygos, subclavian, and RA malpositions, repositioning techniques, and prevention.

guide Clinician Catheter Complications

Catheter Complications: Recognition, Prevention, and Management

Complete clinical reference on catheter complications: thrombosis, occlusion, phlebitis, infiltration, extravasation, air embolism, malposition, and skin injury — recognition, prevention, and evidence-based management.

guide Clinician Complication Management

Product Management and Device Safety

Establishes standards for product evaluation, selection, inspection, problem reporting, and supply chain disruption management to ensure vascular access devices and infusion products meet the highest standards of safety, efficacy, and reliability.

policies Clinician Product Evaluation

Medical Waste and Sharps Safety

Establishes standards for safe handling and disposal of regulated medical waste, sharps safety, needlestick injury prevention, use of safety-engineered devices, injury reporting, and patient and caregiver education for home infusion waste management.

policies Clinician Occupational Safety

Latex Allergy and Sensitivity Management

Establishes standards for minimizing latex exposure, identifying at-risk patients and healthcare workers, managing allergic reactions, and ensuring latex-free care environments for latex-sensitive and latex-allergic individuals.

policies Clinician Allergy

Hazardous Drug Management

Establishes comprehensive standards for the safe handling, preparation, administration, and disposal of hazardous drugs across all care settings, including PPE requirements, engineering controls, environmental monitoring, spill management, and medical surveillance programs.

policies Clinician Pharmacy

Controlled Substance Diversion Prevention

Establishes comprehensive standards for preventing, recognizing, and responding to controlled substance diversion in healthcare settings, including chain of custody requirements, waste management, detection methods, and recovery support for affected healthcare workers.

policies Clinician Patient Safety

Adverse Event Management and Reporting

Establishes comprehensive standards for identifying, documenting, investigating, and learning from adverse events, serious adverse events, and near-miss incidents associated with vascular access devices and infusion therapy.

policies Clinician Patient Safety

Cortisol Levels in Hospital Staff and Work Efficiency

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.

blog Clinician Healthcare Leadership & Administration

Strategic Planning and Implementation of Vascular Access Services

Defines the organizational requirements for the assessment, establishment, governance, financial management, and continuous improvement of a dedicated vascular access specialist service, including leadership structure, team nomenclature, budgetary processes, and interprofessional safety integration.

policies Clinician Administration

Service Delivery Models and Operational Scope

Establishes the organizational model for vascular access service delivery, defining the core service components, operational coverage requirements, consultative approach, and technology integration necessary for a comprehensive, holistic infusion therapy program across inpatient and outpatient settings.

policies Clinician Operations

Scope of Practice and Professional Boundaries in Infusion Therapy

Defines the regulatory hierarchy governing clinician scope of practice, establishes the framework for practice expansion and delegation of vascular access tasks, and delineates the professional roles and responsibilities of all personnel involved in infusion therapy.

policies Clinician Professional Practice

Quality Improvement in Vascular Access

Establishes the organizational framework for continuous quality improvement in vascular access services, including the adoption of validated QI methodologies, audit and feedback mechanisms, adverse event surveillance, medication safety integration, and the maintenance of a Just Culture environment.

policies Clinician Quality Improvement

Patient Education in Infusion Therapy

Mandates comprehensive, health-literacy-appropriate patient and caregiver education for all vascular access and infusion therapy encounters, defines the required educational content, and establishes the teach-back and return demonstration standards for verification of learning.

policies Clinician Patient Education

Interprofessional Safety and Care Transitions

Mandates the integration of vascular access expertise into cross-disciplinary institutional safety programs and establishes the standards for safe care transitions involving patients with indwelling vascular access devices across acute, community, home, and long-term care settings.

policies Clinician Patient Safety

Informed Consent for Vascular Access Procedures

Establishes the legal, ethical, and procedural requirements for obtaining, documenting, and maintaining informed consent for vascular access procedures, including the components of the consent discussion, requirements for emergency situations, and provisions for patients who lack decision-making capacity.

policies Clinician Patient Rights

Foundations of Clinical Practice and Specialized Population Management

Establishes the foundational principles governing the administration of infusion therapy and the management of vascular access devices across all specialized patient populations, including pediatric, neonatal, obstetric, and geriatric cohorts.

policies Clinician Clinical Practice

Evidence-Based Selection and Clinical Monitoring Standards

Mandates that all vascular access device selection, antiseptic agent selection, and infusion technology decisions be rooted in demonstrated clinical evidence and patient outcomes, and establishes the systematic clinical monitoring requirements for all vascular access devices.

policies Clinician Clinical Practice

Evidence-Based Practice (EBP) and Research in Vascular Access

Establishes the organizational commitment to evidence-based practice in vascular access, mandates the continuous revision of policies based on current research, defines the implementation science framework for translating evidence into bedside practice, and outlines the infrastructure requirements for supporting clinician-researchers.

policies Clinician Research

Documentation in the Health Record for Vascular Access

Establishes the standards, requirements, and minimum data elements for clinical documentation of all vascular access events—from insertion through removal—in the electronic health record, including insertion documentation, ongoing assessment, medication administration, and the integration of EHR clinical decision support tools.

policies Clinician Documentation

Competency and Competency Validation in Vascular Access

Establishes the standards, framework, and requirements for initial and ongoing competency assessment and validation for all clinicians performing vascular access and infusion therapy procedures, including educational delivery methods, simulation requirements, insertion training protocols, and program evaluation metrics.

policies Clinician Education

Vascular Access Guidelines & Clinical Practice Guidelines (CPGs)

The definitive index of vascular access clinical practice guidelines — INS Standards, CDC, IDSA, SHEA/IDSA, MAGIC, Joint Commission NPSG, CMS, and the AVA Clinical Practice Guidelines 2026 — with what each covers and when to apply it.

guidelines Clinician Vascular Access

AVA Clinical Practice Guidelines

The Association for Vascular Access (AVA) Adult Clinical Practice Guidelines, published in JAVA as the January 2026 supplement (Volume 31) — full indexed edition in five parts, with section-by-section scope, relationship to INS/CDC/SHEA-IDSA guidance, and citation format.

guidelines Clinician guidelines

AVA CPG 2026 — Part 5: Glossary of Terms

Association for Vascular Access Adult Clinical Practice Guidelines (JAVA 2026, Vol. 31) — Part 5: Comprehensive glossary of vascular access terminology and definitions referenced throughout the guidelines.

guidelines Clinician guidelines

AVA CPG 2026 — Part 1: Guideline Development, Foreword & Introduction

Association for Vascular Access Adult Clinical Practice Guidelines (JAVA 2026, Vol. 31) — Part 1 covering guideline development, acknowledgments, foreword, introduction, and Sections 1–2: Infrastructure, Teams, Clinical Foundations, and Patient Assessment.

guidelines Clinician guidelines

APIs Over Guidelines

Clinical guidelines as static PDFs are failing healthcare. Why API-first medical knowledge distribution is essential for modern clinical decision support, and how The Clinical Database publishes its corpus in machine-readable form.

blog Clinician Healthcare Technology

Vascular Access Device Insertion

Establishes standards for the safe insertion of all vascular access devices, including peripheral intravenous catheters, central venous access devices, and arterial catheters, with requirements for aseptic technique, ultrasound guidance, and complication management.

policies Clinician Vascular Access Procedures

Transmission-Based Precautions

Establishes supplementary infection prevention standards beyond standard precautions for patients with known or suspected communicable disease, including contact, droplet, and airborne precaution requirements, enhanced barrier precautions in long-term care, and crisis standards for pandemic response.

policies Clinician Infection Control

Vascular Access Site Preparation and Skin Antisepsis

Establishes requirements for skin antisepsis and site preparation prior to vascular access device insertion, including antiseptic selection, application technique, and neonatal-specific precautions.

policies Clinician Infection Prevention

Catheter-Associated Skin Injury: Prevention, Assessment, and Management in Vascular Access Care

Evidence-based guidelines for the prevention, assessment, and management of catheter-associated skin injury (CASI) and medical adhesive-related skin injury (MARSI) in patients with peripheral and central vascular access devices, including risk assessment, dressing selection, atraumatic removal techniques, and management of established injury.

policies Clinician Complication Management

Handbook for Infection Prevention Guideline Development

A comprehensive methodology handbook for developing clinical guidelines, expert guidance documents, consensus statements, and practice statements in infection prevention and healthcare epidemiology. Covers proposal processes, systematic literature review, evidence grading, consensus methods, and development timelines.

guidelines Clinician guidelines

Subcutaneous Infusion and Access Devices

Evidence-based standards for subcutaneous infusion therapy including hypodermoclysis, subcutaneous medication administration, continuous subcutaneous insulin infusion, and on-body delivery systems across acute care, ambulatory, and home care settings.

policies Clinician Specialized Devices

Vascular Access Device Post-Insertion Care

Establishes standards for post-insertion care of all vascular access devices, including systematic assessment protocols, dressing selection and change intervals, skin antisepsis, site protection, infection prevention strategies, documentation requirements, and population-specific considerations.

policies Clinician Vascular Access Management

Central Vascular Access Device Malposition: Assessment, Prevention, and Management

Evidence-based guidelines for the assessment, prevention, and management of central vascular access device malposition, including primary and secondary malposition types, prevention through insertion technique, diagnostic evaluation, and management approaches including noninvasive and invasive repositioning.

policies Clinician Complication Management

Pain Management for Vascular Access Procedures

Establishes requirements for evidence-based pain assessment and management during vascular access procedures across all patient populations, from neonates through adults.

policies Clinician Patient Safety

Blood Sampling via Vascular Access Devices

Establishes standards for blood specimen collection from peripheral venipuncture, arterial puncture, peripheral intravenous catheters, central venous access devices, and intraosseous access devices, including patient identification, blood conservation, preanalytical error prevention, and blood culture collection requirements.

policies Clinician Diagnostic Procedures

Neuraxial Access Devices

Evidence-based standards for the safe insertion, management, medication administration, and complication prevention of neuraxial access devices including epidural and intrathecal catheters, implanted neuraxial ports, and intrathecal drug delivery (ITDD) systems across acute care, outpatient, and home care settings.

policies Clinician Specialized Devices

Moderate Sedation and Analgesia via Intravenous Infusion

Evidence-based standards for safe administration of moderate sedation and analgesia through intravenous infusion, covering clinician competency, pharmacologic agents, preprocedural assessment, airway management, continuous monitoring, capnography, post-procedure recovery, and quality improvement.

policies Clinician Sedation

Prevention and Management of Air Embolism in Vascular Access

Evidence-based standards for preventing air embolism during vascular access procedures, including CVAD removal protocols, recognition of signs and symptoms, and emergency response for suspected venous or arterial air embolism.

policies Clinician Complication Management

Administration Set Management

Establishes requirements for the appropriate selection, use, configuration, labeling, and replacement of primary and secondary administration sets for all infusion types, including standard solutions, parenteral nutrition, lipids, blood products, propofol, and hemodynamic monitoring systems.

policies Clinician Infusion Therapy

Aseptic Non-Touch Technique (ANTT®)

Establishes standards for the application of Aseptic Non Touch Technique (ANTT®) across all invasive clinical procedures and vascular access device management, including risk assessment framework, aseptic field management, competency requirements, and environmental management.

policies Clinician Infection Control

Therapeutic Phlebotomy

Clinical guideline for safe and effective therapeutic phlebotomy practice, including vascular access device selection, treatment parameter establishment, adverse effect prevention and management, psychosocial considerations, patient education, and combination therapy for conditions such as polycythemia vera and hereditary hemochromatosis.

policies Clinician Hematology

Vascular Access Policies & Procedures

A library of about 70 institution-ready, evidence-cited vascular access policies — insertion, maintenance and care, complication management, medication administration, blood sampling, infection prevention, and operations — free to read and adaptable with attribution.

policies Clinician Vascular Access

Catheter Damage, Embolism, Repair, and Exchange

Evidence-based standards for preventing catheter damage, recognizing signs of compromise including pinch-off syndrome, and managing catheter damage through repair, exchange, or removal with post-procedure monitoring requirements.

policies Clinician Complication Management

Hand Hygiene

Establishes comprehensive standards for hand hygiene practice across all care settings, including indications, approved techniques, product selection, fingernail and jewelry standards, and organizational compliance strategies to prevent healthcare-associated infections.

policies Clinician Infection Control

Vascular Access for Therapeutic Apheresis

Establishes requirements for vascular access device selection, technical standards, and maintenance protocols for patients undergoing therapeutic apheresis procedures.

policies Clinician Vascular Access

Add-On Devices for Vascular Access Systems

Establishes requirements for the selection, use, configuration, disinfection, and replacement of add-on devices in vascular access infusion systems, including extension sets, manifolds, stopcocks, filters, and closed system transfer devices.

policies Clinician Infusion Therapy

Patient-Controlled Analgesia

Clinical practice guideline establishing standards for safe and effective implementation of patient-controlled analgesia across healthcare settings, including pharmacologic agents, routes of administration, monitoring requirements, and authorized agent-controlled analgesia protocols.

policies Clinician Pain Management

Site Protection and Joint Stabilization for Vascular Access Devices

Establishes standards for protecting vascular access device insertion sites from dislodgement, patient manipulation, and environmental contamination, including joint stabilization practices and the judicious and restrained use of physical immobilization methods.

policies Clinician Vascular Access Management

Catheter-Associated Thrombosis

Evidence-based standards for identifying risk factors for catheter-associated thrombosis, preventing thrombotic complications through device selection and insertion technique, monitoring and diagnosing DVT, and managing confirmed thrombosis including anticoagulation therapy across diverse patient populations.

policies Clinician Complication Management

Flow-Control Devices for Infusion Therapy

Establishes standards for flow-control device selection and use in infusion therapy, including electronic infusion pumps, smart pump dose error reduction systems, non-electronic devices, alarm management, and organizational standardization requirements.

policies Clinician Infusion Therapy

Parenteral Nutrition Administration

Evidence-based clinical guidelines for safe parenteral nutrition administration covering vascular access selection, peripheral PN, filtration requirements, administration set management, infection prevention, patient monitoring, light protection for premature infants, and patient education.

policies Clinician Infusion Therapy

Infusion Medication and Solution Administration

Evidence-based standards for safe administration of infusion medications and solutions, covering verification requirements, clinical appropriateness review, technology integration including barcode scanning and smart pump use, vascular access patency assessment, first-dose protocols, and adverse event reporting.

policies Clinician Infusion Therapy

Implanted Vascular Access Ports

Establishes standards for the access, maintenance, dressing, and patient education requirements for implanted vascular access ports, including noncoring needle selection, flushing protocols, power injection verification, and ongoing device surveillance.

policies Clinician Vascular Access

Filtration in Vascular Access Device Management

Establishes requirements for in-line filtration of parenteral solutions, including mandatory filters for parenteral nutrition and intraspinal infusions, filter selection principles, population-specific indications, change intervals, safety precautions, and prohibited practices.

policies Clinician Infusion Therapy

Compounding and Preparation of Parenteral Solutions and Medications

Evidence-based standards for safe compounding and preparation of parenteral solutions and medications, covering sterile technique, pharmacy-based preparation, vial and ampoule handling, labeling requirements, and competency requirements for all clinicians involved in medication preparation.

policies Clinician Infusion Therapy

Administration of Antineoplastic Therapy

Evidence-based standards for safe preparation, handling, and administration of antineoplastic medications including prescribing authorization, occupational safety and PPE requirements, closed system drug transfer devices, spill management, vesicant administration, and adverse reaction protocols.

policies Clinician Infusion Therapy

Biologic Therapy Administration

Evidence-based standards for safe administration of biologic therapies including colony-stimulating factors, monoclonal antibodies, immunoglobulins, and gene therapies. Covers patient assessment, care setting selection, biosimilar considerations, REMS compliance, subcutaneous immunoglobulin administration, and adverse reaction management.

policies Clinician Infusion Therapy

Umbilical Catheter Management in Neonates

Establishes standards for umbilical arterial catheter (UAC) and umbilical venous catheter (UVC) indications, antisepsis, tip positioning, imaging confirmation, securement, complication surveillance, and removal in neonatal patients.

policies Clinician Neonatal Care

Flushing and Locking of Vascular Access Devices

Establishes standards and requirements for flushing and locking all vascular access devices to maintain catheter patency, prevent occlusion, reduce catheter-associated bloodstream infection risk, and ensure safe medication delivery across all device types and patient populations.

policies Clinician Vascular Access Management

Intraosseous Vascular Access

Evidence-based standards for the clinical evaluation, insertion, management, complication monitoring, and removal of intraosseous vascular access devices across emergent and non-emergent clinical applications in adult and pediatric patients.

policies Clinician Vascular Access

Blood and Fluid Warming

Establishes standards for the warming of blood products, intravenous fluids, and contrast media, including device requirements, temperature limits, prohibited methods, monitoring obligations, and quality assurance for all patient populations including neonates.

policies Clinician Transfusion Medicine

Vascular Access Device Securement

Establishes requirements for the securement of all vascular access devices to prevent complications associated with dislodgement and movement at the insertion site, including acceptable securement methods, device-specific guidance, and assessment standards.

policies Clinician Vascular Access Management

Standard Precautions

Establishes baseline infection prevention standards applicable to all patient care activities regardless of diagnosis, including personal protective equipment selection and use, respiratory hygiene, equipment cleaning and disinfection, and care practices across transitional settings.

policies Clinician Infection Control

Vascular Access for Hemodialysis

Establishes standards for hemodialysis vascular access device selection, vessel health and preservation, access hierarchy, infection prevention, hub care, AVF/AVG cannulation, catheter locking solutions, and patient education for patients receiving or anticipated to receive hemodialysis.

policies Clinician Vascular Access

Blood Administration

Evidence-based standards for safe blood and blood component administration including patient blood management, informed consent, pre-transfusion assessment, product verification protocols, administration procedures, monitoring, adverse reaction recognition and management, and out-of-hospital transfusion requirements.

policies Clinician Transfusion Medicine

Vascular Visualization Technology

Establishes standards for the selection and application of vascular visualization technology—including ultrasound, near-infrared, and visible light devices—to improve vascular access insertion success and reduce complications across all patient populations.

policies Clinician Vascular Access

Needleless Connectors for Vascular Access Devices

Establishes requirements for selection, disinfection, flushing and clamping sequences, replacement intervals, and infection prevention practices for all needleless connectors used on peripheral and central vascular access devices.

policies Clinician Infection Prevention

Infiltration and Extravasation Management

Standards of practice for the prevention, recognition, and management of infiltration and extravasation from peripheral and central vascular access devices, including antidote protocols.

policies Clinician Complication Management

Vascular Access Device Selection and Insertion Planning

Establishes evidence-based criteria for the selection and planning of vascular access devices across all device types and patient populations, from short peripheral catheters through central venous access devices and arterial catheters.

policies Clinician Vascular Access

Phlebitis in Vascular Access Management

Evidence-based standards for the classification, prevention, assessment, and management of phlebitis associated with peripheral and central vascular access devices.

policies Clinician Complication Management

Central Vascular Access Device Tip Location

Establishes standards for central vascular access device tip location confirmation, including acceptable tip positions, real-time tip location methods, re-evaluation protocols, transfer criteria, and documentation requirements for all patient populations.

policies Clinician Vascular Access