Nursing vigilance in preventing catheter fragment migration: a dual case report of peripheral venous catheter fractures in pediatric practice
BackgroundIndwelling venous catheters, including peripheral intravenous catheters (PIVCs), are vital in pediatric care for delivering medications and fluids. However, catheter fractures, though rare (incidence 0%–2.1%), pose serious risks such as pulmonary embolism or cardiac arrhythmias if fragment...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2025.1638983/full |
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| author | Lingling Pu Youcheng Zhang Weibing Chen Hongyan Meng |
| author_facet | Lingling Pu Youcheng Zhang Weibing Chen Hongyan Meng |
| author_sort | Lingling Pu |
| collection | DOAJ |
| description | BackgroundIndwelling venous catheters, including peripheral intravenous catheters (PIVCs), are vital in pediatric care for delivering medications and fluids. However, catheter fractures, though rare (incidence 0%–2.1%), pose serious risks such as pulmonary embolism or cardiac arrhythmias if fragments migrate. While central venous catheter fractures are well-documented, PIVC fractures are underreported despite their widespread use.Case presentationThis report details two pediatric cases of PIVC fractures. In the first, a 1-day-old female neonate experienced a fractured left axillary catheter. Nursing staff promptly applied compression and immobilization, enabling successful surgical retrieval of a 3.5 cm fragment within 6 h, with no complications. In the second, a 1-year-old male infant had a right temporal vein catheter fracture, unrecognized for 6 days due to initial oversight, resulting in localized inflammation. CT angiography and ultrasound confirmed fragment locations, guiding surgical removal of a 1.5 cm fragment.DiscussionThese cases highlight the rarity of PIVC fractures and the pivotal role of nursing vigilance in early detection—marked by signs like resistance during flushing or swelling. Timely interventions, such as compression and immobilization, prevent fragment migration and improve outcomes, as seen in the neonate, contrasting with the delayed case. Risk factors include excessive manipulation, improper site preparation (e.g., unshaved hair), and patient agitation. Preventive measures—thorough hair removal, secure fixation, daily inspections, and agitation management—are critical. Nursing education, standardized protocols, and vascular access teams enhance safety.ConclusionPIVC fractures in pediatrics, though uncommon, demand nursing alertness and swift action. This series underscores the need for preventive strategies and training to optimize patient safety and outcomes. |
| format | Article |
| id | doaj-art-863e5f7b40f6455aa53f34f7db84d1f4 |
| institution | Kabale University |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj-art-863e5f7b40f6455aa53f34f7db84d1f42025-08-20T03:50:49ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-07-011310.3389/fped.2025.16389831638983Nursing vigilance in preventing catheter fragment migration: a dual case report of peripheral venous catheter fractures in pediatric practiceLingling Pu0Youcheng Zhang1Weibing Chen2Hongyan Meng3Department of Operating Room Nursing, Huai’an Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Huai’an, ChinaDepartment of Pediatric Surgery, Huai’an Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Huai’an, ChinaDepartment of Pediatric Surgery, Huai’an Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Huai’an, ChinaDepartment of Pediatric Surgery, Huai’an Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Huai’an, ChinaBackgroundIndwelling venous catheters, including peripheral intravenous catheters (PIVCs), are vital in pediatric care for delivering medications and fluids. However, catheter fractures, though rare (incidence 0%–2.1%), pose serious risks such as pulmonary embolism or cardiac arrhythmias if fragments migrate. While central venous catheter fractures are well-documented, PIVC fractures are underreported despite their widespread use.Case presentationThis report details two pediatric cases of PIVC fractures. In the first, a 1-day-old female neonate experienced a fractured left axillary catheter. Nursing staff promptly applied compression and immobilization, enabling successful surgical retrieval of a 3.5 cm fragment within 6 h, with no complications. In the second, a 1-year-old male infant had a right temporal vein catheter fracture, unrecognized for 6 days due to initial oversight, resulting in localized inflammation. CT angiography and ultrasound confirmed fragment locations, guiding surgical removal of a 1.5 cm fragment.DiscussionThese cases highlight the rarity of PIVC fractures and the pivotal role of nursing vigilance in early detection—marked by signs like resistance during flushing or swelling. Timely interventions, such as compression and immobilization, prevent fragment migration and improve outcomes, as seen in the neonate, contrasting with the delayed case. Risk factors include excessive manipulation, improper site preparation (e.g., unshaved hair), and patient agitation. Preventive measures—thorough hair removal, secure fixation, daily inspections, and agitation management—are critical. Nursing education, standardized protocols, and vascular access teams enhance safety.ConclusionPIVC fractures in pediatrics, though uncommon, demand nursing alertness and swift action. This series underscores the need for preventive strategies and training to optimize patient safety and outcomes.https://www.frontiersin.org/articles/10.3389/fped.2025.1638983/fullcatheter fracturepediatric emergencyretained fragmentvenous access teamstandardized protocols |
| spellingShingle | Lingling Pu Youcheng Zhang Weibing Chen Hongyan Meng Nursing vigilance in preventing catheter fragment migration: a dual case report of peripheral venous catheter fractures in pediatric practice Frontiers in Pediatrics catheter fracture pediatric emergency retained fragment venous access team standardized protocols |
| title | Nursing vigilance in preventing catheter fragment migration: a dual case report of peripheral venous catheter fractures in pediatric practice |
| title_full | Nursing vigilance in preventing catheter fragment migration: a dual case report of peripheral venous catheter fractures in pediatric practice |
| title_fullStr | Nursing vigilance in preventing catheter fragment migration: a dual case report of peripheral venous catheter fractures in pediatric practice |
| title_full_unstemmed | Nursing vigilance in preventing catheter fragment migration: a dual case report of peripheral venous catheter fractures in pediatric practice |
| title_short | Nursing vigilance in preventing catheter fragment migration: a dual case report of peripheral venous catheter fractures in pediatric practice |
| title_sort | nursing vigilance in preventing catheter fragment migration a dual case report of peripheral venous catheter fractures in pediatric practice |
| topic | catheter fracture pediatric emergency retained fragment venous access team standardized protocols |
| url | https://www.frontiersin.org/articles/10.3389/fped.2025.1638983/full |
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