FAILURE TO ATTAIN ELECTROCARDIOGRAM-FACILITATED POSITIONING OF RIGHT ATRIAL CATHETERS WHEN USING THE ARROW(R) ANTECUBITAL CENTRAL VENOUS CATHETERIZATION KIT

When right atrial catheters are used to diagnose and treat venous air emboli in sitting neurosurgical patients, it is possible to position t he catheter tip near the junction of the superior vena cava and right atrium using electrocardiogram (ECG)-based methodologies. This report describes three patients in whom this technique could not be accomplis hed when using the Arrow(R) Antecubital Central Venous Catheterization Kit (Product #AK04250). The problem resulted from an imperfection in the kit's catheter-to-EGG adapter which, in turn, produced an electric al resistance that was 2.5 times greater than normal. Replacement of t he adapters with the Arrow(R)-Johans(TM) ECG Adapter (Product #EG04900 ) reduced the electrical resistance and permitted positioning of the c atheter using the EGG.