Subject(s)
COVID-19/diagnostic imaging , Mobile Health Units , Pneumonia, Viral/diagnostic imaging , Respiratory Distress Syndrome/diagnostic imaging , Ultrasonography/methods , COVID-19/epidemiology , Health Services Accessibility , Humans , Italy/epidemiology , Pandemics , Pneumonia, Viral/virology , Respiratory Distress Syndrome/virology , SARS-CoV-2 , Sensitivity and Specificity , Tomography, X-Ray Computed , TriageABSTRACT
BACKGROUND: Intra-cavitary electrocardiography (ECG) is a well-known method for correct positioning of the tip of central venous catheters (CVC). A significant increase in the P wave, as registered by the intra-cavitary electrode, signals the entrance of the catheter into the right atrium. METHODS: In this prospective observational study, 155 consecutive oncologic patients were enrolled for cannulation of the right or left internal jugular vein for insertion of a tunneled Groshong catheter. In 150 patients the tip was positioned by means of intracavitary ECG. Five patients with atrial fibrillation (N=4) or pacemaker in place (N=1) were excluded from the study. As the P-wave amplitude began to increase, the catheter was secured in that position and the insertion depth was registered. RESULTS: Intra-cavitary ECG was always apt to detect the increase in the P wave. On the post-operative chest x-ray all Groshong catheters except two were in the correct position. CONCLUSIONS: The need for chest x-ray or fluoroscopy may be virtually eliminated by using the ECG technique.