HEMOTHORAX - A SOURCE OF ERROR IN EMERGENCY CENTRAL VEIN CANNULATION

Citation
Jd. Knottenbelt et P. Bautz, HEMOTHORAX - A SOURCE OF ERROR IN EMERGENCY CENTRAL VEIN CANNULATION, South African Journal of Surgery, 31(3), 1993, pp. 120-121
Citations number
NO
Categorie Soggetti
Surgery
ISSN journal
00382361
Volume
31
Issue
3
Year of publication
1993
Pages
120 - 121
Database
ISI
SICI code
0038-2361(1993)31:3<120:H-ASOE>2.0.ZU;2-T
Abstract
Central venous cannulation is often performed in patients with penetra ting wounds of the chest as an aid to diagnosis, and is sometimes also used as a volume infusion resuscitation line in an emergency. The tra ditional signs of successful central venous cannulation - free aspirat ion of blood from the exploring needle and inserted cannula, free infu sion flow and backflow of blood when the set is lowered below the pati ent - may all give a false impression of correct placement if there is a significant haemothorax on the same side. Two cases are described w here the cannula was sited in a pleural cavity which contained blood, leading to inadequate resuscitation of the patient. The authors recomm end that, where possible, peripheral lines or saphenous cutdown be use d for volume resuscitation and that central venous cannulation in the emergency situation be performed on the side of the uninjured hemithor ax, especially if the operator is inexperienced.