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Fundamentals Of Intravitreal Injections: A Guide For Ophthalmic Nurse Practitioners And Allied Health Professionals

Fundamentals Of Intravitreal Injections: A Guide For Ophthalmic Nurse Practitioners And Allied Health Professionals

Waqar Salman | Park Jonathan C

(2018)

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Book Details

Table of Contents

Section Title Page Action Price
CONTENTS v
About the Authors vii
Foreword ix
Acknowledgements xi
1 Introduction 1
2 Basics 3
THE THREE LAYERS OF THE EYE 3
The Retina in Cross Section 6
THE VITREOUS 9
THE LENS 10
3 Investigations 11
OPTICAL COHERENCE TOMOGRAPHY (OCT) 11
FUNDUS FLUORESCEIN ANGIOGRAPHY (FFA) 18
OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY (OCTA) 29
ULTRA-WIDEFIELD IMAGING (UWF) 33
4 Intravitreal Medications and Common Treatment Pathways 35
WHAT ARE THE DIFFERENT ANTI-VEGF PATIENT PATHWAYS? 36
1. Fixed Dosing 37
2. PRN 37
3. Treat and Extend 38
4. Individualised Patient Treatment 39
5 The Technique 41
ONE-STOP AND TWO-STOP CLINICS 41
NEAR-MISS SCENARIOS 42
CRITICAL INCIDENT 44
IMPORTANT POINTS TO REMEMBER 51
6 Complications 53
WRONG PATIENT OR WRONG EYE INJECTED 53
IODINE USED IN A PATIENT WITH IODINE ALLERGY 53
PATIENT COLLAPSE 54
SUBCONJUNCTIVAL HAEMORRHAGE 54
PROBLEMS ASSOCIATED WITH A DILATED PUPIL 54
CORNEAL ABRASION 56
TOXIC EPITHELIOPATHY OF THE CORNEA 57
CATARACT 57
POSTERIOR VITREOUS DETACHMENT AND RETINAL TEAR/DETACHMENT 58
RAISED INTRAOCULAR PRESSURE (IOP) / CENTRAL RETINAL ARTERY OCCLUSION / ISCHAEMIC OPTIC NEUROPATHY 59
AIR BUBBLES 60
VITREOUS WICKS 61
ENDOPHTHALMITIS 61
IMPORTANT STUDY 63
7 Injection Devices 65
MALOSA INTRAVITREAL INJECTION GUIDE (MALOSA MEDICAL /BEAVER-VISITEC INTERNATIONAL) 65
CLINICAL EXPERIENCE 68
INVITREA (FCI OPHTHALMICS), SP.EYE (SD HEALTHCARE) AND RAVI GUIDE (KATALYST SURGICAL) 68
8 Prototype Training Structure 71
1. REQUIREMENTS FOR STAFF PERFORMING INTRAVITREAL INJECTIONS 71
2. REASSESSMENT 72
3. CLINICAL GOVERNANCE 72
4. TRAINING PROGRAMME 73
5. ACCREDITATION 73
6. GUIDELINES FOR ASSESSORS 74
9 Setting Up a Wetlab 77
10 Organising a Dedicated Clean Room 79
Further Reading 81
Appendix A: Intravitreal Injection Checklist 83
PRE-INJECTION ASSESSMENT 83
RECORD OF PROCEDURE 84
NOTES TO ASSIST PRE-INJECTION ASSESSMENT 84
Appendix B: Basic Life Support Algorithm (Resuscitation Council, UK, 2015) 87
Appendix C: Anaphylaxis Algorithm 88
Index 89