Journal of Emergencies, Trauma, and Shock
Home About us Editors Ahead of Print Current Issue Archives Search Instructions Subscribe Advertise Login 
Users online:361   Print this pageEmail this pageSmall font sizeDefault font sizeIncrease font size   
ORIGINAL ARTICLE
Year : 2018  |  Volume : 11  |  Issue : 4  |  Page : 276-281

Electrocardiogram-guided technique: An alternative method for confirming central venous catheter tip placement


1 Department of Emergency Medicine, Amrita Institute of Medical Sciences, Kochi, Amrita Vishwa Vidyapeetham, Amrita University, India
2 Department of Emergency Medicine, Temple University Hospital, Philadelphia, PA, U.S.A
3 Department of Public Health Dentistry, Amrita School of Dentistry, Kochi, Amrita Vishwa Vidyapeetham, Amrita University, India

Correspondence Address:
Dr. Arun Kumar Krishnan
Department of Emergency Medicine, Amrita Institute of Medical Sciences, Kochi, Amrita Vishwa Vidyapeetham, Amrita University
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JETS.JETS_122_17

Rights and Permissions

Background: The current standard followed for assessing central venous catheter (CVC) tip placement location is through radiological confirmation using chest X-ray (CXR). Placement of CVCs under electrocardiogram (ECG) guidance may save cost and time compared to CXR. Objective: The objective of this study is to compare the accurate placement of the CVC tip using anatomical landmark technique with ECG-guided technique. Another objective is to compare CVC placement time and postprocedural complications between the two techniques. Methods and Materials: A total of 144 adult individuals, who were critically ill and required CVC placement in the Emergency Department, were included for the study. Study duration was 6 months. Anatomical landmark and ECG-guided groups were assigned 72 participants each. Analyses were performed using t and Chi square-tests. Results: It was observed that 13 (18%) in the landmark technique were malpositioned as compared to none in the ECG-guided technique (P = 0.000). The landmark group had 22 (30.6%) participants with arrhythmias during the procedure, compared to none in the ECG-guided group (P = 0.000). The landmark group revealed that 30 (41.7%) of the CVC were overinserted and required immediate repositioning, compared to none in the ECG-guided group (P = 0.000). Conclusion: ECG-guided technique was found to be more accurate for CVC tip placement than the anatomical landmark technique. Furthermore, the ECG-guided technique was more time-effective and had less complications than the anatomical landmark technique. Hence, ECG-guided CVC placement is relatively accurate, efficient, and safe and can be considered as an alternative method to conventional radiography for confirmation of CVC tip placement.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed136    
    Printed1    
    Emailed0    
    PDF Downloaded5    
    Comments [Add]    

Recommend this journal