title: Is ECG-guidance a helpful method to correctly position a central venous catheter during prehospital emergency care?
abstract: BACKGROUND
  Insertion of a central venous catheter (CVC) in an emergency situation is challenging and may be potentially associated with more complications. Because CVC positioning by ECG-guidance may help to decrease the frequency of a malpositioned catheter, we decided to prospectively evaluate the usefulness of positioning a CVC by ECG-guidance during prehospital emergency care.
  
  
  METHODS
  Prospective observational study during which all patients requiring CVC placement during prehospital care were included. We compared two periods of 1 year during which CVCs were inserted without and then with the help of ECG-guidance.
  
  
  RESULTS
  Eighty successive patients were included. We observed a significant reduction of incorrectly positioned CVCs with ECG-guidance (13% vs. 38%, P < 0.05) and a decreased number of chest X-rays needed to verify the position of the CVC (40 vs. 54, P < 0.05).
  
  
  CONCLUSIONS
  ECG-guidance is a safe and feasible technique which significantly improved the rate of CVCs correctly positioned during prehospital emergency care.
authors.affiliation: Department of Anaesthesiology, Critical Care and Emergency Medical System, Edouard Herriot Hospital, Hospices Civils de Lyon and Claude Bernard University, Lyon, France. js-david@univ-lyon1.fr
authors.forename: J S
authors.initials: JS
authors.lastname: David
authors.forename: K
authors.initials: K
authors.lastname: Tazarourte
authors.forename: J P
authors.initials: JP
authors.lastname: Perfus
authors.forename: D
authors.initials: D
authors.lastname: Savary
mesh_terms: D000328:Adult; D000368:Aged; D002405:Catheterization, Central Venous / Q000295:instrumentation / Q000379:methods*; D004562:Electrocardiography; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies