Mechanical and infectious complications developing due to central venous catheterizations in  the Emergency Department.
OBJECTIVE
To investigate the rate of catheter-related bloodstream infections (CRBSI) and mechanical complications due to central venous catheter (CVC) insertion in the emergency department (ED) and the contributing factors.


METHODS
A total of 236 patients who were admitted to our ED and underwent CVC insertion between July 2008 and July 2009 were included in this prospective study. The CVC indications, the urgency of the insertion (emergency or elective), catheter complications (mechanical or CRBSI) and the compliance of the emergency physician placing the catheter with infection control and prevention measures were investigated.


RESULTS
The CVC had been inserted urgently in 103 (44%) of the cases and mechanical complication rates in these patients were higher than those receiving it electively (p less 0.05). Our total mechanical complication rate was 27 (11.4%) with the highest rate for femoral catheter (FC). The CRBSI rate was 5/1000 catheter days. None of the physicians inserting a catheter ensured hand hygiene before the procedure.


CONCLUSIONS
The FC is used as the most common access route for a CVC in our ED but CRBSI rate and mechanical complication rate were lower than in the literature. We believe that increasing compliance with infection control and prevention measures, especially hand hygiene, can further decrease the CRBSI rate in the ED.
1Department of Emergency Medicine, School of Medicine, Hacettepe University,  Ankara, 2Department of Emergency Medicine, Ankara Training and Research Hospital, Ulucanlar Ankara, 3Department of Internal Medicine, Section of Infectious Diseases, School  of Medi- cine, Hacettepe University, Ankara; Turkey.
Hayri
H
Ramadan
Nalan
N
Metin Aksu
Meltem
M
Akkas
Mehmet
M
Husamettin Akkucuk
Figen
F
Coskun
Yesim
Y
Cetinkaya Sardan
D000368:Aged; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000382:microbiology; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014421:Turkey / Q000453:epidemiology