Volume 5, No. 2 • Summer 1990

Concerns Raised About CVP Recommendations, Placement Technique

Lee A. Balaklaw, M.D.

To the Editor

The September, 1989 article “Central Venous Catheter Safety Guidelines Issued by Task Force” may be questioned by our neuro anesthesia colleagues.

The recommendations suggested that except for pulmonary artery catheters, the catheter tip should not be placed in the heart. In sitting position craniotomies central venous catheters are always placed in the heart deliberately to aspirate air in the event of an air embolism. Whoever made the recommendations did not consult with our neuro anesthesia brethren. As a result, these recommendations could leave us in a medico-legal pickle

Also, is it now mandatory to use a gown for central venous catheter insertion? I have not worn a gown for these, nor have I had an infected catheter. Is this the new standard of care?

Lee A. Balaklaw, M.D. Cortland, NY

Editor’s note: Replies and suggestions are welcome.