Inadvertent intra-arterial catheterisation using ultrasound guidance and endocavitary electrocardiography in a paediatric patient.

Venous access in small infants is difficult and central venous catheter placed into the brachiocephalic vein is often the preferred approach. Ultrasound guided vein cannulation is standard practice and endocavitary electrocardiography is a reliable catheter tip location method. We report a not immediately recognised 2 month old case of inadvertent intra-arterial catheterisation with a 3 Fr - 8 cm catheter during right innominate vein cannulation under ultrasound guidance.