Comment丨Remove the indwelling needle hose in the child's body, and dismantle the hidden danger "bomb"

Chengdu Business Daily Red Star News

2024-08-08 17:51Posted on the official account of Red Star News of Chengdu Business Daily, Sichuan

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01A 5-month-old child in Yulin was successfully removed from Beijing Children's Hospital affiliated to Capital Medical University with a five-year-old indwelling needle and tube.

02 Five years ago, the nurse's improper operation caused the hose at the tip of the indwelling needle to break in the blood vessels of the child's head, and there have been cases for many years.

03 The head nurse of the neurosurgery department of a hospital in Kunming alone came into contact with 12 cases, and behind them were families who were tormented in seeking medical treatment and making choices.

04To this end, medical institutions should establish complete scalp needle placement operation specifications for children, select high-quality indwelling needle instruments, and formulate emergency treatment plans.

05 At the same time, medical institutions should bear the legal responsibility for serious situations caused by concealment of accidents, delay time, etc., to protect the health of patients.

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How to defuse this hidden danger "bomb" urgently needs a clear and definite pre-prevention and post-resolution mechanism

On June 20 this year, a child in Yulin was surgically removed from the Beijing Children's Hospital affiliated to Capital Medical University with an indwelling needle and flexible needle that had been retained in his body for five years. Five years ago, when a 5-month-old child was seeking medical treatment at a local tertiary hospital in Yulin, the nurse improperly removed the indwelling needle, causing the hose at the tip of the indwelling needle to break in the blood vessels in the child's head.

Recently, according to the Beijing News, the indwelling needle catheter that should have been removed was broken in the vein, although it is a small probability event, but there have been cases for many years. The head nurse of the neurosurgery department in one hospital in Kunming alone has been exposed to 12 cases in 10 years. It is conceivable that behind the numbers are families who are tormented by seeking medical treatment and making choices.

Looking back at the child's history, it was an 18 mm long transparent plastic catheter the thickness of a toothpick, which drifted with the blood in the child's body and disappeared without a trace, becoming a hidden "time bomb" that may puncture blood vessels, form blood clots, or swim to the heart and lungs. In fact, the child had already suffered a failed removal operation, leaving a 10-centimeter-long scar on the child's head. In the following years, the child's parents sought medical attention, but could not find any trace of the hose, until this time it was finally successfully removed.

↑ The scar on the child's head. According to the Beijing News

In clinical practice, intravenous indwelling needles are often used to reduce venous injury caused by repeated punctures. Because the veins of the upper and lower limbs of infants are not fully developed, and the veins of the scalp are more obvious, needles are generally placed from the scalp when venipuncture of infants. The nurse shaves the catheter with a hair clipper when pulling out the needle, which is the main reason for the rupture of the indwelling needle catheter. At the same time, it cannot be ruled out that there may be problems with the quality of indwelling needle instruments. The ruptured catheter remains in the body, like a "bomb" that may be detonated at any time. In addition, the plastic indwelling needle catheter is not transparent to X-rays, and the catheter may not be found. The longer the vascular foreign body remains, the more complications are likely and the more difficult it is to remove. If a ruptured catheter drifts around the blood vessels, it can cause incalculable damage to the child.

Indwelling needle tube rupture is terrifying and can be physically and psychologically "traumatic" to the child and family, and may even pose a life-threatening effect. What's even more frightening is that, according to a nurse manager who has been nursing for 24 years, the vast majority of hospitals currently do not have an emergency treatment mechanism for broken indwelling needles. It can be seen that such situations may not really attract the attention of medical treatment, and how to defuse this hidden danger "bomb" urgently needs a clear and clear pre-prevention and post-resolution mechanism. Don't wait for the incident to happen when the medical staff is still helpless or unwilling to admit the fact that the hose has ruptured, which will waste valuable treatment time and miss the window of emergency treatment.

In view of the fact that such incidents are not rare and the consequences are serious, medical institutions should establish complete scalp needle placement specifications for children, select high-quality indwelling needle devices, require relevant manufacturers to conduct fracture experiments, and clearly put forward strict relevant requirements in national standards. At the same time, once an indwelling needle catheter rupture occurs, the medical institution should have an emergency treatment plan, summarize the successful removal cases, and form an emergency treatment operation specification. If the situation is serious due to the medical institution's concealment of the accident and the delay in time, the medical institution shall bear legal responsibility for the further expansion of the damage.

The indwelling needle and hose were left in the child's body, and finally removed after 5 years of medical treatment, which is a blessing in misfortune for the child's family. However, in the face of the situation of "12 cases in 10 years in one department", we cannot just discuss individual cases on a case-by-case basis. It is necessary to dismantle the "bomb" in the patient's body, but also to dismantle the "bomb" of medical hazards, ensure the operation norms and the quality of the source, do not shirk in case of disputes, and use perfect mechanisms and positive actions to truly protect the health of patients.

Red Star News Special Commentator Shu Shengxiang

Edited by Zhao Yu

Red Star Comment Submission Email: [email protected]

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