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BET 3: Central line insertion in deranged clotting

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Report by: Janos Peter Baombe, Senior Emergency Trainee

Search checked by: Laith Sultan, Senior Emergency Trainee

Institution: Manchester Royal Infirmary, Manchester, UK

Three-part question

In [adult patients presenting to the ED with deranged/unknown clotting profile], does [the insertion of a central line under ultrasound guidance] reduce [the risk of significant bleeding]?

Clinical scenario

A 65-year-old man is brought to the Emergency Department with no recordable blood pressure and a temperature of 39°C. You attempt unsuccessfully to insert a peripheral line several times and you decide to cannulate a central vein. Your colleague asks you if it would not be wiser to wait for the patient's blood coagulation profile to avoid potential bleeding complication.

Search strategy

Medline using the OVID interface 1950 to November week 2 2010.

EMBASE 1980 to December week 2 2010.

Medline: [(exp Catheterisation, Central Venous/) OR …

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