Evaluation of central venous catheters inserted in the emergency departmant

In recent years, the number of central venous catheters installed in emergency departments has been increasing and gaining importance especially in the care of critical patients. In our study, we aimed to investigate the indications, attachment style and method of the central venous catheter procedure performed by Adnan Menderes University Department of Emergency Medicine in the emergency room and emergency intensive care unit, and the complications during and after the intervention. Our hypothesis was that the application of central venous catheter with ultrasound on patients who used anticoagulants and / or antiplatelet would not change the rate of bleeding complications compared to those who did not use anticoagulants and / or antiplatelet. Central venous catheter was applied to our study between the dates of 15.11.2018-15.10.2019 by the department of emergency medicine in emergency department and emergency intensive care unit, 178 cases over the age of 18 and non-pregnant were included. Patient's age, gender, complaints of applying to the emergency department, his / her illnesses, drug use, central venous catheter route and side, catheter placement, total puncture performed to the patient, ultrasound use during the procedure, seniority of the assistant performing successful catheterization, complication status, blood values of the patient, how many days the catheter was left and the patient's outcome were recorded in the case report form. Research data were evaluated by using SPSS 21.0 statistics program. The average age of the patients was 67 (18-96 years). 55.6% of the patients were male and 44.4% were female. 36.5% of the patients had a history of anticoagulant or antiplatelet drug use. When the reasons for applying to the emergency room were evaluated, it was seen that the most common causes were internal causes such as shortness of breath, general condition disorder and nausea-vomiting. The preferred route was found to be the internal jugular vein in 50.6% of the patients, followed by femoral vein and subclavian vein. When looking at the indications of central venous catheter, the most common causes were hemodialysis need, vascular access and central venous pressure measurement, respectively. Successful catheterization was performed in 52.2% of the patients at the first puncture. In the remaining group, successful catheterization was performed in 2 or more punctures. central venous catheter procedure was applied to 78.7% of the patients with ultrasound. Emergency medical assistants who received 44.9% of the patients under 2 years of training, 33.7% of them received 2-3 years of education and 21.3% of them received training of 3 years, central venous catheter. The catheters of the patients were stuck on average for 9 days (1-47 days). The most common complications in our patients were ventricular dysrhythmia and subcutaneous hematoma. When looking at the relationship between gender, anticoagulant and / or antiplatelet drug use, preferred vein and ultrasound use during the procedure and complication status, no statistically significant results were found. However, when the seniority of the physician who performed central venous catheter was examined, it was found that there was a statistically significant result that the complication rates increased as the seniority of the physicians increased. As a result, we think that in patients with anticoagulant and / or antiplatelet drug use, central venous catheter can be performed under emergency conditions under ultrasound. Keywords: Central Venous Catheter, Emergency Room, Complication.