Unintentional arterial cannulation during cephalic vein cannulation

Shivappagoudar, Vikram M; George, Bindu

doi:10.4103/0019-5049.115600

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…Besides nerve injury, arterial injury is also reported a less common complication when puncturing the cephalic vein [ 12 , 13 ]. The arterial injury may occur only when the superficial radial artery is present.…”

Section: Resultsmentioning

confidence: 99%

Clinical anatomy of the cephalic vein for safe performance of venipuncture

et al. 2017

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BackgroundThe aims of this study were to elucidate why the cephalic vein provides a reliable cannulation site from a morphological viewpoint and identify an effective landmark for avoiding injury to the superficial branch of the radial nerve (SBRN), allowing for safe venipuncture of the cephalic vein.FindingsWe examined 32 forearms and wrists from 18 cadavers. The cephalic vein was a constant structure containing a branch communicating with a collateral vein of the deep palmar arch via the first dorsal interossei muscle. The metacarpal vein from the medial two digits flowed into the cephalic vein. The venous confluence formed 5.8 ± 1.2 cm proximal to the radial styloid process. The SBRN passed 0.4 ± 0.3 cm volar to the venous confluence. The distance between the venous confluence and subcutaneous emergence of the SBRN was 2.6 ± 1.0 cm.ConclusionsThese observations suggest that the cephalic vein is a constant structure that serves as a drainage vein of the hand and provides a reliable cannulation site in the forearm. The venous confluence may serve as a novel landmark to predict the running course of the SBRN.

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Section: Resultsmentioning

confidence: 99%

Clinical anatomy of the cephalic vein for safe performance of venipuncture

et al. 2017

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“…This artery has been accidentally cannulated instead of the intended target, the cephalic vein. 39,40 The cannulation of the radial artery in this location was described in two separate case reports. In both instances, the arterial cannulation was noticed prior to drug administration and there were no significant complications.…”

Section: Risk Factors For Iatrogenic Intra-arterial Injectionmentioning

confidence: 98%

“…In both instances, the arterial cannulation was noticed prior to drug administration and there were no significant complications. 39,40 Another anatomical anomaly that predisposes accidental cannulation occurs when the radial artery runs a superficial course through the anatomic snuff box (occurring in 0.5-1% of individuals). 41 The cannulation of this artery, the antebrachialis superficialis dorsalis artery, has been described.…”

Section: Risk Factors For Iatrogenic Intra-arterial Injectionmentioning

confidence: 99%

The incidence, significance, and management of accidental intra-arterial injection: a narrative review

Lokoff

Maynes

2019

Can J Anesth/J Can Anesth

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“…If not promptly recognized, its consequences may include arterial spasm, distal ischemia, and eventual development of limb-threatening gangrene [103]. Risk factors associated with unintentional arterial PIV placement include morbid obesity, dark skin, lack of patient cooperation, significant hypotension, and lack of vigilance [103,104]. Diagnosis: Diagnosis can be made by detecting red pulsatile blood, observing changes in capillary refill, the presence of intense pain, and/or the appearance of distal ischemia.…”

Section: Special Topicsmentioning

confidence: 99%

“…Diagnosis: Diagnosis can be made by detecting red pulsatile blood, observing changes in capillary refill, the presence of intense pain, and/or the appearance of distal ischemia. Confirmation is done by blood gas analysis, pressure transducer placement, and ultrasound [104]. Prevention and treatment: Prevention is the most important measure in this setting.…”

Section: Special Topicsmentioning

confidence: 99%

Dangers of Peripheral Intravenous Catheterization: The Forgotten Tourniquet and Other Patient Safety Considerations

Kaur¹,

Rickard²,

Domer³

et al. 2019

Vignettes in Patient Safety - Volume 4 [Working Title]

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Intravenous catheterization is a widely used invasive procedure, with applications in both ambulatory and hospital settings. Due to its inherently invasive nature, intravenous (IV) therapy is associated with a number of potential complications, many of which are directly relevant to patient safety (PS). PIV-related morbidity may be due to mechanical or nonmechanical factors. The most frequent nonmechanical peripheral venous catheterization adverse events (PVCAEs) include insertion site pain, phlebitis, hematoma formation, and infusate extravasation. The most common mechanical PVCAE is catheter obstruction/occlusion and dislodgement. Significant complications can also occur with the administration of incorrect type or wrong amount of IV fluids. Moreover, simultaneous infusion of incompatible medications can result in infusate precipitation. Finally, less frequent but significant complications have been reported, including bloodstream and local infections, air embolization, nerve damage, arterial puncture, skin necrosis associated with vasopressor infusions, and limb-threatening forgotten tourniquet events. Taken together, the above complications can lead to substantial patient discomfort, unnecessary or prolonged hospitalization, increased costs, and additional downstream morbidity. Efforts to prevent PVCAEs and improve patient outcomes should involve thorough provider education, clinical vigilance by all involved healthcare providers, health service level strategies, as well as the proactive participation of all stakeholders, including patients and their families.

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Unintentional arterial cannulation during cephalic vein cannulation

Cited by 7 publications

References 6 publications

Clinical anatomy of the cephalic vein for safe performance of venipuncture

Clinical anatomy of the cephalic vein for safe performance of venipuncture

The incidence, significance, and management of accidental intra-arterial injection: a narrative review

Dangers of Peripheral Intravenous Catheterization: The Forgotten Tourniquet and Other Patient Safety Considerations

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