Assessment of Sherlock 3cg with intracavitary ECG shows reduced malpositioning of intravenous catheters, suggesting safer practices in vascular access.
Premises and Purpose of the study: In Internal Medicine Ward, the need for long-term vascular access is increasing due to the need to practice intravenous therapy in critically ill patients with poor venous heritage. In our ward we created an internal Vascular Access Team (VAT) composed of 1 doctor and 3 nurses qualified to implant simple and advanced vascular accesses. We use the new SiteRite 8 technology with Sherlock 3cg with intracavitary ECG which allows a complete intraprocedural control until confirming its correct positioning without the need of chest X-ray. The aim of our study is to assess the safety of Sherlock 3cg with intracavitary ECG to check the correct positioning of intravenous catheters compared to X ray control.Materials and Methods: From 01/11/2022 to 31/12/2023, we examined 108 patients, 53 men and 55 women, mean age 75 yo. We positioned 65 peripherally inserted central catheters (PICC) and 45 Midlines: 60 in brachial, 47 in basilica, 1 in cephalic veins. All patients underwent to X-ray control either.Results: Only 2 patients showed malpositioning: in the first case it was suspected at the end of the implantation and in the second the catheter used was too long. No one patient showed catheter thrombosis or infection during hospitalization.Conclusions: In our experience the technology SiteRite8 with Sherlock 3cg with intracavitary ECG assures a reduction in malpositions. The confirmatory chest X ray availability could be limited to cases of doubtful implantation with less discomfort for the patient and less use of human and technological resources.
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