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Broken guide wire--a fault of design?
Enrico Monaca1, Stefan Trojan, John Lynch
1Department of Anesthesiology, Hospital Cologne-Merheim, University Witten/Herdecke, Ostmerheimer Str. 200, D - 51109 Köln, Germany. MonacaE@Kliniken-Koeln.de
Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|September 29, 2005
Summary
Guide wire breakage during central venous catheterization is a rare but serious complication. A simple bedside test can help detect guide wire core section breakage before insertion.
Area of Science:
- Medical Devices
- Interventional Cardiology
- Patient Safety
Background:
- Central venous catheterization is a common procedure in critical care.
- Guide wires are essential tools for facilitating catheter insertion.
- Complications, though rare, can arise from guide wire malfunction.
Observation:
- A 47-year-old critical care patient experienced guide wire breakage during central venous catheterization.
- The J-wire tip lodged in the internal jugular vein.
- Fluoroscopic guidance was required for successful, uneventful removal.
Findings:
- Guide wire breakage during central venous catheter insertion is exceptionally rare.
- Potential causes include inherent design or manufacturing defects.
- A novel bedside test is proposed to identify guide wire core breakage.
Implications:
- Highlights the importance of vigilance for guide wire integrity.
- Suggests a need for improved quality control in guide wire manufacturing.
- The proposed bedside test could enhance patient safety during central venous catheterization.