An Engineering Solution to Prevent Guidewire Retention in Central Venous Line Placement
Student Team: Team Guardwire
Tuan, Trinh, MD, Children’s Healthcare of Atlanta
A retained guidewire during central venous catheter (CVC) placement is a rare complication of a very common procedure. Guidewire retention can result in severe medical consequences for the patient and legal fees and compromised reputations for the hospital. Current methods to prevent guidewire retention from occurring are focused on procedural solutions and have not been shown to significantly reduce incidence of guidewire retention. An engineering solution is needed to address this problem, and such a device must be safe for the patient and must be a realistic solution for the clinician to adopt. Keeping this in mind, Team Guardwire set about developing an engineering solution to prevent guidewire retention. After brainstorming, prototyping, and testing a number of possible solutions, Team Guardwire came up with the preloaded guidewire solution. The preloaded guidewire is designed to make guidewire retention impossible during CVC placement. The preloaded guidewire consists of a guidewire that comes with a peel-away dilator and CVC already placed on it, with a cap at the end of the guidewire to prevent distal migration of the guidewire through the catheter and into the patient. When tested in SolidWorks, the preloaded guidewire cap, called WireGuard, was shown to be able to withstand at least 21 times the force a guidewire needs to withstand to be safe for use. Team Guardwire’s solution of the preloaded guidewire provides a physical, engineering solution to the problem of guidewire retention when there is currently no other realistic engineering solution on the market.