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Localization of CVP Catheter with Teflon Wire

Brendan Phibbs, MD
JAMA. 1968;205(3):188. doi:10.1001/jama.1968.03140290080032.
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To the Editor:—  The recent report of death following "Perforation of the Atrium by a Polyethylene CV Catheter" (203:1141, 1968) is particularly tragic because such accidents do not need to occur. The authors discuss two possible means of localizing central venous pressure catheters, ie, radiopaque tips and etched calibration markings. A simpler and more precise method has been available for some time and is in routine use at this and other hospitals (New Eng J Med274:270, 1966). The central venous pressure catheter is localized electrocardiographically by means of a Tefloncoated wire which is placed inside the catheter so that the tip of the wire protrudes 1 or 2 mm. The proximal end of the wire is connected to the unipolar lead of the ECG, which we have finally found to be more satisfactory than the left arm lead, as we originally described. Sharp, clear, diagnostic ECG complexes


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