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October 13, 1956


JAMA. 1956;162(7):685. doi:10.1001/jama.1956.02970240067024

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To the Editor:—  I wish to comment on the article "Venostomy, an Improved 'Cut-Down' Procedure in Infants and Children," by Miles and Harris (J. A. M. A.161:619 [June 16] 1956). Most aspects of the technique described and illustrated are excellent; however, there is one dangerous omission. The illustration accompanying the article shows the polyethylene tubing extending straight out of the cut-down to the needle. This is extremely dangerous, since any weakening of the catheter wall by repeated insertion of the needle or flexion of the tubing against the needle, or an error in handling replacement of the needle, may result in the polyethylene tube being carried away into the blood stream. I personally know of five such instances. In one of these, a nurse was changing the needle inserted in the cannula and let go of the polyethylene tube just for an instant, only to see the tube

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