背景:静脉插管插入很重要,鉴于这是急诊科最常见的血液采样程序,液体复苏,和静脉注射药物。静脉导管插入术的并发症包括疼痛,静脉炎,外渗,炎症,和栓塞。静脉插管的骨折很少见,但是延迟移除可能会导致二次损伤,如血管炎或栓塞,有严重的后果。这里,我们报告一例发生在急诊科的静脉内插管骨折.
方法:一名有左卵巢癌病史的63岁女性因口服摄入不足和全身无力而到我们的急诊科就诊。熟练的操作人员尝试使用18号套管进行静脉导管插入以进行静脉输液。但由于静脉塌陷和皮肤状况不佳而失败。经过几次尝试,病人手上的一条静脉破裂,病人抱怨剧烈疼痛。套管被移除,但是三分之一的套管尖端看不见。进行X射线成像以定位套管的碎片,在急诊科进行静脉切开术以去除异物。
结论:急诊医师和护士应警惕可能导致静脉插管骨折的潜在危险因素,骨折被发现后,应在急诊科快速取出插管尖端.
BACKGROUND: Intravenous cannula insertion is important, given that it is the most common invasive procedure in the emergency department for blood sampling, fluid resuscitation, and intravenous drug administration. Complications of intravenous catheterization include pain, phlebitis, extravasation, inflammation, and embolization. Fracture of an intravenous cannula is rare, but delayed removal may result in secondary damage, such as vasculitis or embolization, with critical consequences. Here, we report a
case of intravenous cannula fracture that occurred in our emergency department.
METHODS: A 63-year-old woman with a history of left ovarian cancer visited our emergency department owing to poor oral intake and general weakness. Intravenous catheterization using an 18 gauge cannula was attempted for intravenous fluid administration by a skilled operator, but it failed owing to collapsed veins and poor skin condition. After several attempts, a vein in the patient\'s hand was ruptured, and the patient complained of severe pain. The cannula was removed, but one-third of the cannula tip could not be seen. X-ray imaging was performed to locate the fragment of the cannula, and venotomy was performed for removal of the foreign body in the emergency department.
CONCLUSIONS: Emergency physicians and nurses should be vigilant about potential risk factors that can cause fracture of an intravenous cannula, and after the fracture is discovered, rapid removal of the cannula tip should be performed in the emergency department.