Application of 16 cases of ECG localization in positioning specific signals at the tip of PICC catheter in lower limbs

Abstract

Objective Electrocardiographic (ECG) localization was used to guide the placement of peripherally inserted central catheters (PICC) catheter in the lower extremity. In clinical practice, the interference factors that may affect the localization results were further analyzed to reduce the interference factors. Methods From August 2016 to October 2018, Zhejiang Provincial People's Hospital implanted PICC catheter into the great saphenous vein of the lower extremity in 16 patients who had been placed into the central vein in advance because the upper extremity could not be placed into the PICC catheter. Based on the principle of ECG and the morphological change of P wave of ECG, the accuracy of the tip location of PICC guided by ECG was observed, and the possible interference factors in the process of ECG location were analyzed comprehensively, coping measures were implemented as well. Results 16 patients were guided by ECG to locate the tip of lower extremity PICC, 14 patients showed inverted P wave in ECG location, 16 patients showed the tip of catheter in the best position recommended by the guide on abdominal plain film, which was effective after targeted treatment of possible interference factors considered in the practice. Conclusions It is simple, safe and effective to use the ECG localization to locate the tip of PICC in lower extremity. It has better clinical practicability and popularization value. Key words: Electrocardiography; Positioniny technology; PICC; Tip