Safe Central Venous Access in an Overburdened Health System

JAMA. 2021 Jan 19;325(3):299-300. doi: 10.1001/jama.2020.20361.

Abstract

A previously healthy man, intubated in the intensive care unit (ICU) for respiratory failure due to coronavirus disease 2019 (COVID-19), required central venous access for vasopressor infusion. The intensivists were occupied managing other critically ill patients, so an available intern attempted to place a triple-lumen catheter in the right internal jugular vein using only anatomic landmarks for guidance. When the access needle was inserted, pulsatile return of blood was noted.

MeSH terms

  • COVID-19 / complications
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / standards*
  • Catheterization, Central Venous / statistics & numerical data
  • Health Care Surveys
  • Humans
  • Jugular Veins / injuries*
  • Male
  • Medical Errors* / statistics & numerical data
  • Patient Care Team
  • Respiratory Insufficiency / etiology
  • Respiratory Insufficiency / therapy
  • Root Cause Analysis