An Unusual Cause of Asystole: Insertion of a Central Venous Catheter

Central venous catheters are a commonly used medical device which may sometimes cause complications. We present first case who had an asystolic cardiac arrest during insertion of a central venous catheter, needed cardiopulmonary resuscitation (CPR), and was resuscitated successfully. A 46-year lady presented to the emergency department due to mushroom poisoning. A central venous catheter was inserted through the internal jugular vein. However, the patient suddenly lost consciousness and asystole was seen on the monitor immediately after the insertion of the catheter. Cardiopulmonary resuscitation was started, and the catheter was withdrawn nearly 5 cm. Spontaneous circulation returned 2 minutes later. The patient was hospitalised, hemodialysis was performed, and she was discharged the next day. Emergency physicians should be prepared for dysrhythmias and asystole during insertion of a central venous catheter. If cardiac arrest develops, the catheter should be withdrawn a few centimeters while CPR continues.