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Focus on patient safety « Central venous catheter and air embolism ... One bubble is all it takes »
In 2019, the French national survey of serious care-related adverse events in healthcare facilities revealed that such events continued to occur in critical care departments and that, in contrast with other sectors, their incidence density had not decreased in these settings since 2009 [1] [2].
An analysis of critical care-related serious adverse events reported by healthcare professionals revealed that central venous catheters could be implicated in the occurrence of serious air embolism, and that the events concerned were very often avoidable. Given that in 2017, 63.3% of intensive care patients (n= 43,412) had a central venous catheter[3] and that these are also used outside critical care departments (operating theatre, chemotherapy, etc.), it seemed important to publish feedback on this subject.
Objectives
By sharing feedback relative to the occurrence of air embolisms during the management of central venous catheters, this Focus on Patient Safety aims to:
- alert healthcare professionals and care teams about the occurrence of serious CRAEs that could have been avoided by following good clinical practice;
- help reduce the risks related to central venous catheter management;
- improve information and training for healthcare personnel on good clinical practice for central venous catheter management.
So it doesn’t happen again
Based on an analysis of the serious care-related adverse events reported, they are usually caused by a lack of awareness of the risk, inadequate training of personnel, the absence of a department procedure, poor practice or a failure to monitor the patient.
Main key messages to prevent these events :
- Always assess the need for a central venous catheter and the benefit-risk balance.
- Always have trained personnel insert, maintain and remove central venous catheters.
- Always bear in mind the risk of air embolism and take care when handling the central venous catheter.
[1] https://sante.gouv.fr/IMG/pdf/eneis_3_2019_.pdf
[3] https://www.santepubliquefrance.fr/import/surveillance-des-infections-nosocomiales-en-reanimation-adulte-reseau-rea-raisin-france-resultats-2017
