[Intracavitary electrocardiogram during the insertion of peripherally inserted central catheters]

Area of Science:

• Vascular Access
• Medical Device Technology
• Diagnostic Techniques

Context:

• Peripherally inserted central catheters (PICCs) are crucial for long-term venous access.
• Accurate tip placement of PICCs is essential to prevent complications.
• Current verification methods may be time-consuming or require additional resources.

Purpose:

• To assess the applicability, feasibility, and accuracy of the intracardiac electrocardiogram (IC-ECG) with a saline column technique for PICC tip verification.
• To evaluate the performance of this technique when utilized by specialist nurses.

Summary:

• The IC-ECG with saline column technique demonstrated an applicability of 84.4% and feasibility of 88% in 84 out of 99 inserted PICCs.
• The accuracy of the IC-ECG technique for PICC tip verification was 87.8%, as compared to chest x-ray.
• The study found the technique to be easy to apply, cost-effective, and achievable by nurses, with no associated patient risk.

Impact:

• The IC-ECG technique offers a safe, in situ method for verifying PICC tip position during insertion.
• Successful implementation by nurses can lead to reduced catheter malposition and fewer re-insertions.
• This technique has the potential to improve patient outcomes and optimize healthcare resource utilization.