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September 1949

FATAL INTERSTITIAL AND MEDIASTINAL EMPHYSEMA: Following Accidental Needle Perforations of the Trachea During Jugular Venipuncture

Author Affiliations

From the Office of the Chief Medical Examiner, City of New York.

Am J Dis Child. 1949;78(3):375-383. doi:10.1001/archpedi.1949.02030050388009

THE PHYSICIAN is often called on to puncture the veins of an infant, either to obtain a sample of blood for diagnostic purposes or to administer therapy. As a rule, the antecubital veins are too small for this procedure unless a vein is exposed through an incision in the skin. In order to avoid this difficulty larger calibered veins are employed, such as the longitudinal dural sinus beneath the fontanels or the femoral or the internal jugular veins; the last-mentioned vessel is usually the one of choice. This vein, however, lies in close lateral proximity to the trachea and tracheal perforation in connection with such venipuncture can readily occur. Such accidents have not been thus far recorded in the literature.

It is, therefore, my purpose in this paper to report 2 cases of accidental fatal perforation of the trachea in infants during venipuncture of the internal jugular vein and to

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