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Published on: December 23, 2014
Is ECG-guidance a helpful method to correctly position a central venous catheter during prehospital emergency care?
J S David1, K Tazarourte, J P Perfus
1Department of Anaesthesiology, Critical Care and Emergency Medical System, Edouard Herriot Hospital, Hospices Civils de Lyon and Claude Bernard University, Lyon, France. js-david@univ-lyon1.fr
Background:
Insertion of a central venous catheter (CVC) in an emergency situation is challenging and may be potentially associated with more complications. Because CVC positioning by ECG-guidance may help to decrease the frequency of a malpositioned catheter, we decided to prospectively evaluate the usefulness of positioning a CVC by ECG-guidance during prehospital emergency care.
Methods:
Prospective observational study during which all patients requiring CVC placement during prehospital care were included. We compared two periods of 1 year during which CVCs were inserted without and then with the help of ECG-guidance.
Results:
Eighty successive patients were included. We observed a significant reduction of incorrectly positioned CVCs with ECG-guidance (13% vs. 38%, P < 0.05) and a decreased number of chest X-rays needed to verify the position of the CVC (40 vs. 54, P < 0.05).
Conclusion:
ECG-guidance is a safe and feasible technique which significantly improved the rate of CVCs correctly positioned during prehospital emergency care.
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