Cause analysis and nursing countermeasure of misdiagnosis of PICC catheter internal carotid vein in 32 cases

Objective: To analyze the causes of missed diagnosis and improve nursing countermeasures in patients with PICC catheterization of internaljugular vein. Methods: We conducted a retrospective study of 32 patients who weren’t diagnosed ectopic catheterizations of internal jugularvein until they had X-ray examinations after ultrasound guided PICC catheterization. We analyzed the reasons of missed diagnosis to providea certain guidance for clinical practices. Results: The missed diagnosis of ectopic catheterizations of internal jugular vein were caused bysmall exploratory area of internal jugular vein, improper usage of ultrasonic probe, operation step missing, variations of veins and so on. Thefirst two reasons are the main factors. Conclusion: In order to reduce the occurrence of missed diagnosis of ectopic PICC catheterizations ofinternal jugular vein, the operators should expand the exploratory area of internal jugular vein, use the ultrasonic probe correctly, improve theoperation level, follow the operation procedure strictly and evaluate patients’ preoperative situations carefully. If all the measures above aretaken, we can assuredly reduce the rate of missed diagnosis of ectopic PICC catheterizations of internal jugular vein.