He believes that a major factor is the design of the equipment, and in particular the length of the introducing dilator.
The internal jugular vein in the neck is always within easy reach of a standard needle, which typically measures 3.5 cm in length, explains the author. However the typical length of the dilator provided by most manufacturers for line insertion is almost 20 cm, so when it is placed fully within the vein in the neck as required its tip is lying within the heart.
A dilator of this length is rarely needed, he adds. “If we could persuade manufacturers to reduce its length to 10 cm in standard packs then the complication from which this patient died simply could not occur.”
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