Healthcare and Medicine Reference
In-Depth Information
should be contacted urgently. The wire needs to be removed as
an emergency.
In the longer term any central line is a potential site for
introduction of infection and for colonisation by micro-
Further reading
Hind D, Calvert N, McWilliams R, Davidson A, Paisley S, Beverley C,
Thomas, S. (2003) Ultrasonic locating devices for central venous cannula-
tion: meta-analysis. Br Med J 327: 361-70.
McGee DC, Gould MK. (2003) Current concepts: preventing complications
of central venous catheterization. N Engl J Med 348: 1123-33.
National Institute for Health and Clinical Excellence. (2002) The clinical
effectiveness and cost effectiveness of ultrasonic locating devices for the
placement of central venous lines. NICE technology appraisal guidance 49 .
Figure 11.8 A chest X-ray showing a 'lost' guidewire: an emergent thoracic
opinion is indicated.
Handy hints/troubleshooting
The most common complication of this procedure is infection;
strict aseptic technique must be adhered to.
Always spend time positioning your patient; this maximises the
chances of success fi rst pass.
Read the notes to identify sites which have been used before as
'virgin sites' are easier.
Practise using the US on your colleagues - this will improve your
anatomical knowledge.
Be careful when suturing the line in position - this is where the
most 'needlesticks' from this procedure occur!
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