scholarly journals A Catastrophe Caused by Central Venous Catheter Insertion – A Case Report

2016 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Cardiac Arrhythmias ◽  
Inferior Vena ◽  
Central Venous Catheterization ◽  
Guide Wire ◽  
Vena Cava ◽  
Air Embolism ◽  
Venous Catheter ◽  
Central Venous Catheter Insertion ◽  
Central Venous ◽  
Venous Catheterization

Central venous catheterization (CVC) is a routine technique done in critical care and emergency departments for monitoring patients and giving certain parenteral medications in special conditions. Most common complications associated with CVCs are infection, hematoma, hemothorax, pneumothorax and superior or inferior vena cava trauma while rare complications include cardiac arrhythmias, air embolism and loss of the guide wire [1].

Pre- and post-review of a standardized ultrasound-guided central venous catheterization curriculum evaluating procedural skills acquisition and clinician confidence

2019 ◽  
Vol 21 (4) ◽  
pp. 440-448 ◽  
Author(s):  
Timothy R Spencer ◽  
Amy J Bardin-Spencer
Keyword(s):  
Central Venous Catheter ◽  
Central Venous Catheterization ◽  
Venous Catheter ◽  
Catheter Insertion ◽  
Central Venous Catheter Insertion ◽  
Ultrasound Guided ◽  
Central Venous ◽  
Clinical Simulation ◽  
Venous Catheterization ◽  
Simulation Based

Background: To evaluate novice and expert clinicians’ procedural confidence utilizing a blended learning mixed fidelity simulation model when applying a standardized ultrasound-guided central venous catheterization curriculum. Methods: Simulation-based education and ultrasound-guided central venous catheter insertion aims to provide facility-wide efficiencies and improves patient safety through interdisciplinary collaboration. The objective of this quality improvement research was to evaluate both novice (<50) and expert (>50) clinicians’ confidence across 100 ultrasound-guided central venous catheter insertion courses were performed at a mixture of teaching and non-teaching hospitals across 26 states within the United States between April 2015 and April 2016. A total of 1238 attendees completed a pre- and post-survey after attending a mixed method clinical simulation course. Attendees completed a 4-h online didactic education module followed by 4 h of hands-on clinical simulation stations (compliance/sterile technique, needling techniques, vascular ultrasound assessment, and experiential complication management). Results: The use of a standardized evidence-based ultrasound-guided central venous catheter curriculum improved confidence and application to required clinical tasks and knowledge across all interdisciplinary specialties, regardless of level of experience. Both physician and non-physician groups resulted in statistically significant results in both procedural compliance ( p < 0.001) and ultrasound skills ( p < 0.001). Conclusion: The use of a standardized clinical simulation curriculum enhanced all aspects of ultrasound-guided central venous catheter insertion skills, knowledge, and improved confidence for all clinician types. Self-reported complications were reported at significantly higher rates than previously published evidence, demonstrating the need for ongoing procedural competencies. While there are growing benefits for the role of simulation-based programs, further evaluation is needed to explore its effectiveness in changing the quality of clinical outcomes within the healthcare setting.

scholarly journals Incidentally Detected Asymptomatic Thrombus in the Inferior Vena Cava Thought to be Caused by Central Venous Catheterization for an Oral Surgical Procedure

2020 ◽  
pp. 1-2
Author(s):  
Shigeru Takuma ◽  
Shigeru Takuma ◽  
Yukifumi Kimura ◽  
Nobuhito Kamekura ◽  
Toshiaki Fujisawa
Keyword(s):  
Inferior Vena Cava ◽  
Surgical Procedure ◽  
Inferior Vena ◽  
Central Venous Catheterization ◽  
Vena Cava ◽  
Perioperative Period ◽  
Central Venous ◽  
Common Procedure ◽  
Venous Catheterization ◽  
Oral Surgical Procedure

Central venous catheterization (CVC) is a common procedure in the perioperative period, and thrombosis is one of the well-known complications of CVC. If the thrombus comes free from the vascular wall, it may cause serious problems such as pulmonary embolism. However, in some cases of inferior vena cava thrombosis, the patient has no symptoms, and thrombus is detected accidentally. A case in which asymptomatic thrombus in the inferior vena cava was incidentally detected following removal of the CV catheter after an oral surgical procedure is described.

scholarly journals Identification and correction of guide wire malposition during internal jugular cannulation with ultrasound

CJEM ◽  
2007 ◽  
Vol 9 (02) ◽  
pp. 131-132 ◽  
Author(s):  
Michael B. Stone
Keyword(s):  
Real Time ◽  
Ultrasound Guidance ◽  
Central Venous Catheterization ◽  
Guide Wire ◽  
Venous Catheter ◽  
Central Venous ◽  
Venous Catheterization ◽  
Procedural Complications ◽  
Introducer Needle ◽  
Wire Resistance

ABSTRACT Real-time ultrasound guidance for central venous catheterization increases success and reduces procedural complications. I describe a case in which guide wire resistance was encountered and real-time ultrasound visualization of the guide wire facilitated correction of guide wire malposition. No additional passes of the introducer needle were necessary and the chances of inadvertent carotid artery puncture or pneumothorax were therefore reduced. The technique described here may prove valuable when guide wire resistance is encountered while placing a central venous catheter.

scholarly journals Coiling of shaft of the central venous catheter inside left subclavian vein- a case report

2018 ◽  
Vol 4 (2) ◽  
pp. 87-90
Author(s):  
Lalit Kumar Rajbanshi ◽  
Shambhu Bahadur Karki ◽  
Batsalya Arjyal
Keyword(s):  
Central Venous Catheter ◽  
Central Venous Catheterization ◽  
Guide Wire ◽  
Venous Catheter ◽  
Anatomical Landmarks ◽  
Central Venous ◽  
Venous Catheterization ◽  
Left Subclavian Vein ◽  
The Common ◽  
Blood Aspiration

Central venous catheterization is one of the common procedures used for gaining vascular access for various indications. Sometimes, the catheter can take unusual course inside the vein that can lead to erroneous pressure measurement, increase the risk of thrombosis or trauma to the vessel. Any resistance during insertion of the guide wire or catheter and absence of blood aspiration are some alarming signs that help to detect malposition at the earliest moment. We report a case of coiling of the shaft of the central venous catheter inside left sublacvian vein in a patient with head injury. Technical expertise, sound knowledge of anatomical landmarks and use of real time ultrasound can minimize malposition of the catheter. We suggest at any moment if there is resistance during insertion of guide wire or catheter or if there is absence of blood aspiration from any of the lumen, the catheter should be removed immediately suspecting malposition.Journal of Society of Anesthesiologists of NepalVol. 4, No. 2, 2017, page: 87-90 

Persistent Left Superior Vena Cava and Partially Left Inferior Vena Cava: A Case Report of a Dangerous Central Venous Catheterization

2017 ◽  
Vol 18 (5) ◽  
pp. e66-e69 ◽  
Author(s):  
Biagio Ricciardi ◽  
Carlo Alberto Ricciardi ◽  
Antonio Lacquaniti ◽  
Giuseppe Carella ◽  
Domenico Puzzolo ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Superior Vena Cava ◽  
Inferior Vena ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Catheter ◽  
Central Venous ◽  
Left Superior Vena Cava ◽  
Venous Catheterization

Background The coexistence of a double superior vena cava (SVC) and a partially left inferior vena cava (PLIVC) with a circumaortic collar, associated with other congenital malformations, was not described previously. Case Description We present a 33-year-old woman in hemodialysis with complete exhaustion of the brachial routes for vascular access, admitted to our Nephrology Unit for a long-term central venous catheter (CVC) implant, usually by us performed under EchoScopic Technique (EST), an echographic venipuncture followed by continuous radioscopic control of guidewire and catheter in all the steps of implant. An intraoperative venography showed a complete stop of right internal jugular vein, a right SVC, a persistent left SVC, a left inferior vena cava in the iliac and subrenal tracts, a circumaortic venous collar in the renal tract, and normal right suprarenal and hepatic tracts. Conclusions The double SVC was related to the persistence of the caudal part of the anterior cardinal veins. As to the PLIVC, the iliac and subrenal parts of the inferior vena cava can be related to the persistent left supracardinal vein, while the circumaortic venous collar to the persistent intersupracardinal and left subsupracardinal anastomoses. All invasive procedures, and particularly those potentially complicated, must be performed under EST, now considered a mandatory tool for CVC implants, owing to the hypothesis of possible venous congenital anomalies.

Central venous access

2019 ◽  
Vol 80 (8) ◽  
pp. C114-C119
Author(s):  
Joel Lockwood ◽  
Neel Desai
Keyword(s):  
Central Venous Catheter ◽  
Central Venous Catheterization ◽  
Superior Vena ◽  
Central Venous Access ◽  
Vena Cava ◽  
Venous Catheter ◽  
Seldinger Technique ◽  
Haemodynamic Monitoring ◽  
Central Venous ◽  
Venous Catheterization

Central venous catheterization is the placement of a catheter in such a manner that its tip is positioned within the proximal third of the superior vena cava, the right atrium or the inferior vena cava. It is indicated when access for administration of drugs or extracorporeal blood circuits and haemodynamic monitoring or interventions is needed. When inserting a central venous catheter, appropriate preparation and asepsis, positioning of the patient, and the use of ultrasound should be considered. Compared to the landmark method of localization, ultrasound can account for anatomical variations, facilitate visualization of venous puncture, and safeguard against inadvertent arterial puncture. In the Seldinger technique, which is the primary mode of central venous catheterization, a needle is passed towards the chosen vessel. Once the needle is in the vein, a guidewire is introduced through the needle into the vessel and the needle is removed. Following a small skin incision at the base of the guidewire, a dilator is advanced over the guidewire and then taken out. Subsequent to this, the central venous catheter is railroaded over the guidewire into the vein and the guidewire is withdrawn. Complications of central venous catheterization can be mechanical, infectious or thrombotic.

scholarly journals Depth of Central Venous Catheterization: An Audit of Practice in a Cardiac Surgical Unit

1994 ◽  
Vol 22 (3) ◽  
pp. 267-271 ◽  
Author(s):  
J. S. Rutherford ◽  
A. F. Merry ◽  
C. J. Occleshaw
Keyword(s):  
Central Venous Catheterization ◽  
Main Bronchus ◽  
Superior Vena ◽  
Vena Cava ◽  
Venous Catheter ◽  
Azygos Vein ◽  
Central Venous ◽  
Venous Catheterization ◽  
The Right ◽  
Surgical Unit

Central venous catheter (CVC) depth relative to the cephalic limit of the pericardial reflection (CLPR) was assessed retrospectively in 100 adult patients from chest radiographs taken after admission to the intensive care unit. A well known landmark proved to be considerably influenced by parallax; therefore we located the CLPR by a new landmark, the junction of the azygos vein and the superior vena cava, identified by the angle of the right main bronchus and the trachea. The majority (58) of CVC tips lay below the pericardial reflection on the first chest radiograph (CXR). Of these only two had been corrected by the time of the next routine CXR. No case of cardiac tamponade secondary to erosion by a CVC could be remembered, or identified from records of routine departmental audit meetings, for the last ten years. Nevertheless, reported incidents of this complication have often been fatal and vigilance is necessary in any patient with a CVC.

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