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Hemiplegia Following Fluid Administration Through an Implanted Venous Access Device: A Case Report
James Waymack1, Christopher McDowell1, Nida Feller1
1Southern Illinois University School of Medicine, Department of Emergency Medicine, Springfield, Illinois.
Clinical Practice and Cases in Emergency Medicine
|February 28, 2022
Summary
Accidental arterial placement of central venous catheters can cause serious complications, including stroke. Emergency physicians must recognize this risk, especially when symptoms arise after fluid administration through a malpositioned line.
Area of Science:
- Emergency Medicine
- Vascular Access
- Neurology
Background:
- Central venous access is common in emergency departments.
- Inadvertent arterial placement of these catheters can lead to adverse events.
Purpose of the Study:
- To highlight the potential for unrecognized arterial malposition of central venous catheters.
- To emphasize the risk of cerebral ischemia from fluid administration through malpositioned lines.
Main Methods:
- Case report of a 63-year-old man with hemiplegia.
- Description of diagnosis after initial presentation and discharge for stroke-like symptoms.
Main Results:
- Intra-arterial placement of a central venous catheter was diagnosed on a subsequent visit.
- The patient experienced hemiplegia following intravenous fluid administration.
Conclusions:
- Emergency physicians must be vigilant for arterial malposition of central lines.
- Unrecognized arterial placement can lead to cerebral ischemia, particularly with fluid infusions.
- Awareness of this complication is crucial for patient safety.
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