MedBugs: SAQ #53

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Case: CVC Complication

A 50-year-old female was seen in your tertiary ED 1 week prior with a deliberate OD of sustained release verapamil. She required intubaton prior to administration of activated charcoal. The ED registrar on shift inserted a central line into the right IJV to facilitate ongoing management.

1. Aside from pneumothorax, list (3) immediate complica ons which may arise following inser on of a central line in the internal jugular vein. 3 marks

The patient became hypotensive after insertion of the central line. A CXR confirms the presence of a tension pneumothorax.

2. List (3) features of radiological tension on a CXR. 3 marks

A complaint is made through the patient liaison officer against the department as a result of the adverse incident. An open disclosure process has been commenced with the family.

3. State (3) steps you would take to investigate and (3) steps to manage the incident. 6 marks

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Case: CVC Complication

1. Aside from pneumothorax, list (3) immediate complica ons which may arise following inser on of a central line in the internal jugular vein. 3 marks

2. List (3) features of radiological tension on a CXR. 3 marks

3. State (3) steps you would take to investigate and (3) steps to manage the incident. 6 marks

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