Becton, Dickinson and Company · NYSE:BDX
Becton, Dickinson and — Technical Presentation (April 2020)
44 slides from Becton, Dickinson and's technical presentation, April 2020
Slide 1: Presenter views disclaimer
These presentations were developed by the respective presenter(s), and the findings, interpretations, and conclusions contained or expressed with them do not necessarily reflect the views of BD. To the extent these presentations relate to specific products, such products should always be used in acc
Slide 2: MACOVA2020 Multidisciplinary Advanced Course on Vascular Access
re ae oy eee °@ ve wee Peee, ee. - ak eT ° Ce . .¢ ect2eeee ° . ee 20 ee ee eh Cee . eye i ) MACOVA2020 * Multidisciplinary Advanced Course on Vascular Access © BD oe
Slide 3: Holistic approach to vascular access in the emergency department
Holistic approach to vascular access in the emergency department Prof. Baudolino Mussa IVAS President
Slide 4: Emergency Department: news…
Emergency Department: news…
Slide 5: Emergency Department: news – increased survival for chronic patients
Emergency Department: news… - Increased survival for chronic patients
Slide 6: Emergency Department: news – medium age increased
Emergency Department: news… - Medium age of population increased
Slide 7: Emergency Department: news – short postoperative stay
Emergency Department: news… - Short hospital stay in postoperative period
Slide 8: Emergency Department: news – previous EV treated patients
Emergency Department: news… - High rate of previous EV treated patients
Slide 9: Venous access: what type, when and for how long?
Venous access: what type, when and for how long?
Slide 10: Venous access: what type?
Venous access: what type?
Slide 11: Devices
Devices: • peripherally-inserted central catheters (PICCs) • centrally-inserted central catheters (CICCs and FICCs) • peripheral intravenous catheters (PIVCs)
Slide 12: Devices: are all the same for quality and durability?
Devices: • peripherally-inserted central catheters (PICCs) • centrally-inserted Are all the same for central catheters quality and (CICCs) durability? • peripheral intravenous catheters (PIVCs)
Slide 13: Short- and Intermediate-Term Use of PICCs in Europe: Systematic Review
MACOVA220_ REVIEW ARTICLE Short- and Intermediate-Term Use of Peripherally Inserted Central Catheters in Europe: A Systematic Literature Review Baudolino Mussa, MD CVC Team Torino, Department of Surgical Science, University of Turin, Turin, Italy Corso Achille Mario Dogliotti 14, Turin, Italy Kim Al
Slide 14: Literature Extraction
Litterature Extraction ‘MACOVA2020. c : S 3 569 records identified 28 additional records identified Ss through database searching through conference abstract and 5 grey literature sources z= 2 457 records after duplicates removed < 5 a 457 records screened 258 records excluded 2 = 199 full-text arti
Slide 15: Results: Efficacy Outcomes with PICCs and Comparators
Results ‘MACOVA2020 Table 3. Summary of Efficacy Outcomes with PICCs and Comparators PICC 96.8 (1) 0-18 (5) 1.15*-1.16 (2) 7.9-176.1 (6) 9.4-127 (21) 0-7.4 (16) PIVC 79.3 (1) 23.4 (1) 2.27 (1) NR 4.4-7.3 (2) NR cicc NR 12.2 (1) 1(1) 22.5-98.5 (2) 6.83-324.92 (6) NR n= number of interventions; NR = n
Slide 16: Results: Efficacy Outcomes and Conclusions
Results MACOVA220. Table 3. Summary of Efficacy Outcomes with PICCs and Comparators Patient Number of Mean catheter Sa Sa —EE Ss ee Conclusions: This review showed that PICCs offer several advantages compared to CICCs and PIVCs, including greater patient satisfaction, fewer complications leading to
Slide 17: What about Port a Cath?
What about Port a Cath? • Long term discontinued therapy (best for use every 28 days) • All power injectable device For valved power Pac flushing every 3 months available
Slide 18: What about Picc Port?
What about Picc Port? • Device with same defects of PAC and PICC (underskin, low flow, pain for use). • The only indication is saltuary therapy in patient with thorax area not avaiable for implant (Bilateral mammarian cancer, thorax RT ecc.) • Actually implanting kit is incomplete and procedure more
Slide 19: What about Tunnelled CVC?
What about Tunnelled Cvc? • Long term continued therapy (best for use every day) • Silicon device can be repaired (long term use) • Usable also by patient himself (2 hands avaiable) • In our experience on NPT patients longest survival of device
Slide 20: What is the difference in Picc World?
What is the difference in Picc World? • Valve design • Material
Slide 21: What is the difference in Picc World? Valve design, material
What is the difference in Picc World? • Valve design Silicon • Material Poliuretane
Slide 22: Randomized comparison of valved and non-valved PICCs
Jase Access 2014 15 (6) 519-523 ORIGINAL ARTICLE DOK: 10.520Vjva.5000280 A prospective, randomized comparison of three different types of valved and non-valved peripherally inserted central catheters Mauro Pittiruti', Alessandro Emoli?, Patrizia Porta?, Bruno Marche?, Rosa DeAngelis, Giancarlo Scopp
Slide 23: Open- vs Closed-Tip Valved PICCs and Midlines
Po evicw nericcs snblo Namber ot Patent and inpiant bays Open- vs Closed-Tip Valved Peripherally = @o-»- sex Inserted Central Catheters and Midlines: — — — Findings from a Vascular Access Database ° = CEA Female 750 73.325 ‘Antonio Canelli, RN AO. Melegnano, Milan, aly Total 1416 135.778 No. of pati
Slide 24: A registry… we need it
A registry... we need it The Need for Comparative Data in Vascular Access: The Rationale and Design of the PICC Registry Constance Girgenti, RN, VA-BC Presence St Joseph Medical Center, Joliet, IL. ‘Nancy L. Moureau, BSN, CRNI PICC Excellence, Inc, Hartwell, GA Approximately 43 million peripherally
Slide 25: Picc Registry
Picc Registry • Big numbers…. Right answers • Real situation in Italy experience • Concrete help for choose the right device
Slide 26: Retrospective study of safety of over 100,000 PICC days
RE SEARCH RESEARCH ARTICLE WILEY aT A retrospective study of the safety of over 100,000 peripherally-inserted central catheters days for parenteral supportive treatments Sara Campagna PhD, RN? | Silvia Gonella RN, MSc, PhD student?® | Paola Berchialla PhD? | Carla Rigo RN* | Giacomo Morano MD® | Pie
Slide 27: Results: Patient and PICC characteristics
Results: TABLE 1 Patient and PICC characteristics according to the reason for PICC removal: Bivariate analysis (n = 1,250) PICC removal PICC removal because : All patients because of of other reasons Variables (n= 1,250) (n= 178) (n= 1,072) Pp Patient characteristics Female sex, n (%) (n= 914) 520 [
Slide 28: Results: Patient and PICC characteristics and conclusions
Results: TABLE 1 Patient and PICC characteristics according to the reason for PICC removal: Bivariate analysis (n = 1,250) PICC removal PICC removal because All patients because of of other reasons Variables (n= 1.250) (n= 178) (n= 1.072) cand 0.23 per 1,000 PICC days, respectively. The median dwell
Slide 29: First conclusions….
First conclusions…. PICC, CICC and PIVC all could be used safely in Emergency department.
Slide 30: Some idea…..
Some idea….. 1) Question: how many flow do I need? 2) How many lines do I need? 3) Has patient a VAD? 4) Is the VAD working correctly? 5) Is the VAD useful for our use? 6) Does VAD must used after ED?
Slide 31: Some idea….. How much flow do I need?
Some idea….. 1) Question: how many flow do I need? For high flow better a CICC For low flow better a Picc If there is a VAD check and use, for more flow Powerglide or Power Midline
Slide 32: Some idea….. How many lines do I need?
Some idea….. 2) How many lines do I need? Picc lines have until 3 lines. Midline also If VAD present possible to place Powerglide Or Power Midline
Slide 33: Some idea….. VAD questions
Some idea….. 3) Has patient a VAD? 4) Is the VAD working correctly? 5) Is the VAD useful for our use? 6) Does VAD must used after ED? Take in mind patient’s future
Slide 34: What is good:
What is good: • US guidance for VAD • ECG check for tip • Veins saving algorithm • Reduce infection VAD related • New class of VAD • New products
Slide 35: What is good:
What is good: • US guidance for VAD • ECG check for tip • Veins saving algorithm • Reduce infection VAD related • New class of VAD • New products
Slide 36: What is good:
What is good: • US guidance for VAD • ECG check for tip • Veins saving algorithm • Reduce infection VAD related • New class of VAD • New products
Slide 37: What is good:
What is good: • US guidance for VAD • ECG check for tip • Veins saving algorithm • Reduce infection VAD related • New class of VAD • New products
Slide 38: What is good:
What is good: • US guidance for VAD • ECG check for tip • Veins saving algorithm • Reduce infection VAD related • New class of VAD • New products
Slide 39: What is good:
What is good: • US guidance for VAD • ECG check for tip • Veins saving algorithm • Reduce infection VAD related • New class of VAD • New products
Slide 40: What is BAD:
What is BAD: • Thrombosis • Difficult treatment for infection • Bad patient communication • Too much PIV and too much bad placed
Slide 41: What is BAD:
What is BAD: • Thrombosis • Difficult treatment for infection • Bad patient communication • Too much PIV and too much bad placed
Slide 42: What is BAD:
What is BAD: • Thrombosis • Difficult treatment for infection • Bad patient communication • Too much PIV and too much bad placed
Slide 43: What is BAD:
What is BAD: • Thrombosis • Difficult treatment for infection • Bad patient communication • Too much PIV and too much bad placed
Slide 44: Patient first
Patient first
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