Deogaonkar K, Shokrollahi K, Dickson W A
Welsh Centre for Burns & Plastic Surgery, Morriston Hospital, Morriston, Swansea SA6 6NL, United Kingdom.
Resuscitation. 2007 Jan;72(1):161-3. doi: 10.1016/j.resuscitation.2006.06.020. Epub 2006 Nov 27.
Central venous cannulation forms one of the mainstays of management of trauma and haemodynamically unstable patients. Frequently this procedure has to be done as an emergency in the emergency department. Ultrasound guidance has been recommended, especially for use by trainee members of the emergency department. We report a case of 44% full thickness burns with subclavian artery puncture due to a misplaced central venous catheter. This led to massive haemothorax, which eventually caused the patient to succumb. We re-emphasise the need for ultrasound guidance for insertion of central venous lines, especially in the emergency setting.
中心静脉置管是创伤和血流动力学不稳定患者治疗的主要手段之一。通常,该操作必须在急诊科作为紧急情况进行。超声引导已被推荐,特别是供急诊科实习人员使用。我们报告一例因中心静脉导管位置不当导致锁骨下动脉穿刺,造成44%全层烧伤的病例。这导致了大量血胸,最终导致患者死亡。我们再次强调在插入中心静脉导管时,尤其是在紧急情况下,需要超声引导。