Ultrasound exam for differentiating guidewire's misplacement into brachial artery during PICC insertion through subclavian vein / 中国实用护理杂志

ABSTRACT

Objective Introducing ultrasound exam method for detecting accidental displacement of guidewire into brachial artery during one type of PICC placement. Methods Select 145 patients with PICC placement as objects of study. During procedure, use EKG guidance for localization. After successfully inserted the needle into a vein and threaded the guidewire through the needle, then apply ultrasound to show the guidewire image to verify whether or not the guidewire is advanced into brachial artery at any moment. After the procedure, a chest X-ray is taken for location confirmation. Results 144 patient's guidewire ultrasound images were seen inside the subclavian vein. One patient's guidewire ultrasound image was shown inside the subclavian artery, which confirms it was accidentally advanced into the brachial artery during insertion. The guidewire was removed immediately, only scant bleeding occurred. Conclusions By utilizing ultrasound to show the guidewire image inside subclavian vein, it will help differentiate if it is accidentally advanced into the brachial artery at any moments during PICC insertion. It assists avoiding complications after advancing the catheter. It is easy to perform and helpful for wide clinical use.