Background: Post-medical procedure complications are a critical area of healthcare, often resulting from infections, device failures, or unforeseen physiological responses. These events, while rare, can have significant impacts on patient safety and outcomes, even leading to mortality. Robust preventive measures and post-procedure monitoring are thus necessitated. This study analyzed trends and disparities in mortality rates [...]

Background: Diagnosis of complications is important for patient care, diagnostic quality, and safety. Paracentesis is a common procedure among hospitalized patients. The use of ultrasound decreases complications and improves safety. We aimed to characterize the complication rate observed among paracenteses performed by a hospital medicine bedside procedures service (MPS) before and after a transition to [...]

Background: The midline catheter (midline) has emerged as a reliable vascular access device for peripherally compatible infusates. Current guidelines recommend midlines when the intended dwell is ≤14 days since little is known about its safety beyond this period. We sought to describe characteristics and outcomes of midlines that dwell for >14 days. Methods: Trained abstractors [...]

Background: Kidney Dialysis is a vital treatment for patients with end-stage renal disease. But lately, there has been an alarming increase in deaths related to this procedure. This study analyzed mortality trends and disparities among adults aged 15 and older from 1999 to 2020. Methods: The study examined post- kidney dialysis complications-related mortality in the [...]

Background: Intravenous vancomycin treatment is often necessary beyond hospitalization. Peripherally inserted central catheters (PICCs) are usually placed for this indication. Whether the less invasive midline catheters (midlines) are safe alternatives for outpatient parenteral antimicrobial therapy (OPAT) with vancomycin is unclear. We compared the safety of midlines and PICCs among patients receiving vancomycin for OPAT. Methods: [...]

Background: Difficult intravenous access is a common challenge in patients with obesity, often resulting in placement of peripherally inserted central catheters (PICCs). However, little is known about the relationship between obesity and the risk of device-related complications in patients with PICCs. We sought to assess associations between obesity and PICC-related complications in hospitalized medical patients. [...]

Background: Routine transfusion of platelets and Fresh Frozen Plasma (FFP) prior to paracentesis is among the “things we do for no reason”, as recommended against by the American Association of Liver Disease and American Gastroenterology Association in patients with platelets over 20,000. We hypothesize that a Medicine Procedure Service (MPS), which has adopted this recommendation [...]

Background: Tracheostomies are commonly performed on critically ill patients requiring prolonged respiratory support. Managing them in intermediate care units (IMCU) presents challenges, as complications such as tube displacement, infection, and airway obstruction can pose significant risks. Structured safety protocols like checklists have been successfully used in other high-risk healthcare settings to mitigate these risks. Thomassen [...]

Case Presentation: A 57-year-old female with end-stage renal disease (ESRD) on hemodialysis and a history of calciphylaxis presented with a non-healing wound on her right hand. Two months prior, she developed a wound on the dorsal surface of her right fourth finger without antecedent trauma. The lesion became painful and discolored, resistant to multiple courses [...]

Case Presentation: A 63-year-old female with paroxysmal atrial fibrillation managed with apixaban status post biventricular pacemaker implantation a year ago presented with persistent chest pain and worsening dyspnea over the past week, accompanied by bilateral lower extremity pain. She reported a persistent “poking” sensation in her chest, particularly with movement. Vitals were stable and afebrile. [...]