Arterial lines are routinely used for haemodynamic monitoring in critically ill patients and they are associated with a low incidence of major complications. We present a case of radial arterial cannula fracture which necessitated surgical removal. Ultrasound played a crucial role in both identifying the cannula fragment and aiding surgical retrieval. Arterial line fracture is a rare complication of arterial cannulation but patient safety could be improved through a revision of how cannulas are secured to prevent kinking, fatigue and subsequent fracture. We suggest arterial lines should have marked or coloured tips to aid practitioners in ensuring the entire cannula length is removed with the distal tip intact.
this instance. unlike in many other areas of toxicology. Additional laboratories may well have similar packed-column capacity which can be put to use in this way. Dr Smith emphasises, as we did, the importance of resolving the phenylboronate derivatives of propylene and ethylene glycols and we submit that partial resolution is acceptable, since both compounds are unlikely to be present in the same sample. We felt it prudent to point out that peakbroadening might occur with the direct injection assay if injection volumes greater than 3 ilL were used since 3-5 III volumes are common in packed column work. We fail to see why this should be thought of as indicative of a problem with the assay as described. Similarly, the fact that we drew attention to the possibility of 'carry-over' of ethylene glycol cannot be said to render the procedure 'inadequate'. the more so since we pointed out that acidification of the derivatising reagent eliminated the circumstances under which such carry-over had been observed. We note that Dr Smith I reported degradation of baseline stability. peak shape, and peak quantitation after each batch of analyses when using his method; injections of 5-10 III water and elevation of the column temperature to 28(fC for 15-20 min were required to restore column performance. In conclusion, although we have not disputed that Dr Smith has produced a reliable method for ethylene glycol analysis, we feel that our observations will prove useful to others who might wish to operate such an assay routinely.
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