Keywords
broken catheter, ultrasound, echography,
broken catheter, ultrasound, echography,
Peripheral intravenous (IV) catheters are given every day to many patients, without much attention given to possible complications. The complications are usually minor, for instance phlebitis or subcutaneous injection of solutions. However, when placement is difficult and the needle of the IV catheter is reinserted for another attempt, the needle can cut the catheter and damage it in such a way that it might break while inside the vein. These fragments can migrate to the right side of the heart, both atrium and ventricle, evidenced by reports in the literature1,2.
We present the case of a 90 year old caucasian patient where only half of the peripheral IV catheter was retrieved after removal. By using ultrasound the remaining part of the catheter was identified and removed.
The patient was admitted to the hospital with a contained ruptured aneurysm of the abdominal aorta. The patient underwent emergency surgery and an aortic bifurcation prosthesis was placed. According to the anaesthesiologist who cared for the patient, the peripheral catheter was used to administer the anaesthetics and induction of anaesthesia went as planned. After induction, a central venous catheter was placed and the peripheral catheter was no longer used. Post operatively the patient was admitted to the intensive care unit (ICU) where the peripheral catheter was removed and only the proximal half of the catheter came out. We examined the arm but could not palpate the remaining part of the catheter. Ultrasound examination, performed by the ICU resident, showed an echogenic hollow tube (Figure 1), eight centimeters proximal of the insertion site of the catheter. The surgeon made a small incision and the remaining part of the catheter was removed (Figure 2). We were not able to trace the person who placed the IV catheter, to evaluate the technique used.
This case describes the succesful use of ultrasound as a diagnostic tool for difficulties encountered after peripheral IV catheter removal.
We hypothesize that the needle was reinserted in the catheter during placement because placement was difficult. By doing so, the needle may have cut the distal part of the catheter. Reinserting a needle back into a catheter can be dangerous, and there is a risk of damaging the catheter or cutting it off and thereby allowing the free part of the catheter to migrate to the heart, a consequence that could be disastrous and would make removal of the catheter far more difficult3,4. The use of ultrasound made a quick diagnosis and enhanced treatment possible, thereby preventing further complications.
Written informed consent for publication of clinical details and clinical images was obtained from the patient.
PJS wrote the manuscript. PRT and SvR revised the manuscript. All authors contributed to design of the manuscript and approved the final version for publication.
Views | Downloads | |
---|---|---|
F1000Research | - | - |
PubMed Central
Data from PMC are received and updated monthly.
|
- | - |
Is the background of the case’s history and progression described in sufficient detail?
Yes
Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes?
Yes
Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment?
Yes
Is the case presented with sufficient detail to be useful for other practitioners?
Yes
Competing Interests: No competing interests were disclosed.
Is the background of the case’s history and progression described in sufficient detail?
Yes
Are enough details provided of any physical examination and diagnostic tests, treatment given and outcomes?
Yes
Is sufficient discussion included of the importance of the findings and their relevance to future understanding of disease processes, diagnosis or treatment?
Yes
Is the case presented with sufficient detail to be useful for other practitioners?
Yes
Competing Interests: No competing interests were disclosed.
Alongside their report, reviewers assign a status to the article:
Invited Reviewers | ||
---|---|---|
1 | 2 | |
Version 1 03 May 17 |
read | read |
Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. Consider the following examples, but note that this is not an exhaustive list:
Sign up for content alerts and receive a weekly or monthly email with all newly published articles
Already registered? Sign in
The email address should be the one you originally registered with F1000.
You registered with F1000 via Google, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Google account password, please click here.
You registered with F1000 via Facebook, so we cannot reset your password.
To sign in, please click here.
If you still need help with your Facebook account password, please click here.
If your email address is registered with us, we will email you instructions to reset your password.
If you think you should have received this email but it has not arrived, please check your spam filters and/or contact for further assistance.
Comments on this article Comments (0)