Hemiplegia Following Fluid Administration Through an Implanted Venous Access Device: A Case Report.

James Waymack,Christopher Mcdowell,Sharon Kim,Nida Feller

doi:10.5811/cpcem.2021.12.55230

Abstract

IntroductionMany patients seen in the emergency department (ED) have central venous access placed or previously established placement. Catheters inadvertently placed in the arterial circulation may lead to complications or adverse events.Case ReportWe present a case of hemiplegia in a 63-year-old man following intravenous fluid administration through a malpositioned catheter that was initially unrecognized. The patient initially presented to the ED for stroke-like symptoms and was discharged following workup. On a subsequent visit for similar symptoms, intra-arterial placement of the catheter was diagnosed.ConclusionIt is important for emergency physicians to be aware of this potential complication of central venous cannulation and that arterial malposition of a previously placed central line may go unrecognized with the potential to cause cerebral ischemia when cerebral blood flow is reduced by the infusion of intravenous fluids or medications.

Highlights

Many patients seen in the emergency department (ED) have central venous access placed or previously established placement
It is important for emergency physicians to be aware of this potential complication of central venous cannulation and that arterial malposition of a previously placed central line may go unrecognized with the potential to cause cerebral ischemia when cerebral blood flow is reduced by the infusion of intravenous fluids or medications. [Clin Pract Cases Emerg Med. 2022;6(1):76-79.]
We present a case of hemiplegia following intravenous (IV) fluid administration through an implanted venous device that had been inadvertently placed in the subclavian artery and unrecognized as such until malposition was identified on computed tomography angiography (CTA) of the chest following a stroke evaluation

Summary

Introduction

Many patients seen in the emergency department (ED) have central venous access placed or previously established placement. Catheters inadvertently placed in the arterial circulation may lead to complications or adverse events. Case Report: We present a case of hemiplegia in a 63-year-old man following intravenous fluid administration through a malpositioned catheter that was initially unrecognized. The patient initially presented to the ED for stroke-like symptoms and was discharged following workup. On a subsequent visit for similar symptoms, intra-arterial placement of the catheter was diagnosed

Conclusion

INTRODUCTION

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CONCLUSION