Is this right IJ central line correctly placed as noted on chest x-ray?

Blue dot marks tip of IJ.   Contrast adjusted to maximize clarity of IJ and tracheobronchial angle.  Click on image to enlarge.

IJ should be pulled back 1-2 cm.  Ideal location is at the superior vena cava/atrial junction which is located  3-5 cm below the tracheobronchial angle, a distance which is reproducible in patients despite gender and body habitus. 


Source

Emedhome.com.  Clinical Pearls: "Proper Position of a Central Line."  7 April 2010.

Marcucci, L. Avoiding Common ICU Errors.  "Place the Tip of a Central Venous Catheter at the Junction of the Superior Vena Cava and Atrium"  Lippincott Williams & Wilkins.  2007.
on 1/19/2012 Posted by Dr. Bearemy
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4 comments:

  2. you mean the Svc/Atrial junction?

    ReplyDelete

  3. @ fon8686,

    Yes, the SVC. I've modified the post. Thank you!

    ReplyDelete

  4. One other thing to remember is that it's much easier to pull a catheter back but, an infectious risk to advance further. I am surprised they didn't see any ectopy with this picture.

    ReplyDelete

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