title: Accidental carotid artery catheterization during attempted central venous catheter placement: a case report.
abstract: More than 2.1 million central venous catheters are placed annually. While carotid artery cannulation is rare, its effects can be devastating. Anesthesia providers frequently work with central venous catheters in the perioperative setting. Therefore, it is imperative that they be able to identify and react appropriately to carotid artery injury both in preexisting central lines and those that they have placed. This case report details a case of accidental carotid artery catheterization during attempted right internal jugular vein catheterization and the steps taken to treat the patient following its recognition. A discussion of technique for central venous catheterization, indications for suspicion of arterial puncture, methods for confirming venous or arterial placement, appropriate methods for management of carotid artery cannulation, and the benefit of ultrasound in central venous cannulation follow. Through the appropriate use of equipment, early detection and management of carotid artery injury, and proper training, patient outcomes may be improved.
authors.affiliation: New York Presbyterian/Weill Cornell Medical Center, New York, New York, USA. pmm2127@columbia.edu
authors.forename: Pauline Marie
authors.initials: PM
authors.lastname: Maietta
mesh_terms: D000368:Aged; D020212:Carotid Artery Injuries / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D006801:Humans; D007601:Jugular Veins; D008297:Male; D009719:Nurse Anesthetists; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D018084:Ultrasonography, Interventional