Electrocardiograma intracavitario durante el implante de catéteres centrales de inserción periférica / Intracavitary electrocardiogram during the insertion of peripherally inserted central catheters

Objetivo Valorar la aplicabilidad, la factibilidad y la precisión de la técnica del IC-EKG con columna de suero en la verificación de la posición final de la punta del catéter central de inserción periférica (PICC) llevado a cabo por enfermeras especialistas. Método Se han implantado PICC en 99 pacientes consecutivamente. Se han excluido pacientes sin onda P en el EKG de superficie, pacientes con fibrilación auricular y pacientes con marcapasos. La técnica del IC-EKG se ha aplicado en 84 pacientes. Tras el implante se ha realizado placa de tórax a todos los pacientes y se ha comparado con el IC-EKG. Resultados Hemos obtenido una aplicabilidad del 84,4%, una factibilidad del 88% y una precisión del 87,8%. Conclusiones La técnica IC-EKG para la posición de la punta del PICC con columna de suero es fácil de aplicar, coste-eficaz, aplicable por enfermeras y no implica riesgos para el paciente. Supone la superación de una curva de aprendizaje y su ejecución por personal formado. La técnica se ejecuta durante el implante del PICC, por lo que la verificación se realiza in situ y con ello se disminuyen posteriores implantes por mal posicionamiento de la punta (AU)

Objective To evaluate the applicability, feasibility and accuracy of the IC-ECG with column of saline technique for verifying the final tip position of peripherally inserted central catheters (PICC) by specialist nurses. Method A total of 99 consecutive PICC were inserted. Patients with no superficial ECG P wave, atrial fibrillation, or a pacemaker were excluded. The IC-ECG technique was performed on 84 patients. A chest x-ray was performed after insertion in all cases, in order to compare images with IC-ECG. Results The technique showed an applicability of 84.4%, an feasibility of 88%, and an accuracy of 87.8%. Conclusions The IC-ECG technique for verification of catheter PICC tip locations with column of saline is easy to apply, is cost-effective, is achievable by nurses, and does not involve any risk for patients. The technique involves a learning curve, and it must be performed by qualified health care professionals. The technique is performed during the insertion of the catheter, so verification of the tip is made in situ. It reduces future re-insertions due to wrong positioning of the tip (AU)

[Intracavitary electrocardiogram during the insertion of peripherally inserted central catheters]. / Electrocardiograma intracavitario durante el implante de catéteres centrales de inserción periférica.

OBJECTIVE: To evaluate the applicability, feasibility and accuracy of the IC-ECG with column of saline technique for verifying the final tip position of peripherally inserted central catheters (PICC) by specialist nurses. METHOD: A total of 99 consecutive PICC were inserted. Patients with no superficial ECG P wave, atrial fibrillation, or a pacemaker were excluded. The IC-ECG technique was performed on 84 patients. A chest x-ray was performed after insertion in all cases, in order to compare images with IC-ECG. RESULTS: The technique showed an applicability of 84.4%, an feasibility of 88%, and an accuracy of 87.8%. CONCLUSIONS: The IC-ECG technique for verification of catheter PICC tip locations with column of saline is easy to apply, is cost-effective, is achievable by nurses, and does not involve any risk for patients. The technique involves a learning curve, and it must be performed by qualified health care professionals. The technique is performed during the insertion of the catheter, so verification of the tip is made in situ. It reduces future re-insertions due to wrong positioning of the tip.