A bedside rescue method for retrieving retained guidewires: The 'Suck Out' technique

Area of Science:

• Medical Devices
• Patient Safety
• Interventional Radiology

Background:

• Central venous catheter guidewire retention is a serious complication, classified as a 'never event' in the UK.
• Existing bedside retrieval methods may fail if the guidewire has passed below the skin surface.
• Investigated a new 'suck out' technique for improved guidewire retrieval.

Purpose of the Study:

• To evaluate the efficacy of a novel 'suck out' technique for retrieving retained central venous catheter guidewires.
• To compare the 'suck out' technique against traditional retrieval methods in simulated scenarios.

Main Methods:

• Benchtop simulations assessed guidewire retraction using a 50-mL syringe and suction.
• A pigskin model simulated retained guidewires above and below skin level.
• Compared 'suck out' technique with simple catheter withdrawal and catheter clamping withdrawal.

Main Results:

• The 'suck out' technique retracted guidewires by an average of 13 cm in benchtop models.
• When retained below skin level, 'suck out' achieved 90% retrieval efficacy versus 10% for clamping and withdrawal (p < 0.001).
• All methods were 100% effective when guidewires were retained above skin level.

Conclusions:

• The 'suck out' technique is an effective method for guidewire retrieval within central venous catheters.
• This novel technique demonstrates superior performance compared to traditional methods in simulated settings.
• The findings suggest potential for enhanced patient safety by reducing complications from retained guidewires.