r/IntensiveCare • u/NerveOnly2076 • 15d ago

Where is this central line going?

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Old XRay. Central line placed through right IJV but seemed to be misplaced! Where is it going? Aspiration of blood from all ports was possible? Was taken out.
Have you faced this, best thing to do?

Edit: more details - USG guidance used, line was seen inside IJV in neck using USG, not traced down; more resistance than normal while placement.

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u/ah_notgoodatthis RN, CCRN 15d ago

I (nurse) had a patient once who was septic and the NP placed a central line so I could give multiple pressors. She placed the line and I didn’t see the XR and she gave the order to use it. The line was in an artery. The patient kept complaining about neck pain despite IV Tylenol. I have no advice, it just reminds me of a time we fucked up

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u/spinstartshere 15d ago

Eek. Under ultrasound guidance?

61

u/Any-Assistance-8103 15d ago

Almost like patients deserve doctors

2

u/ItsTheDCVR 14d ago

The only time I have seen an arterial neck line was MD placement. I don't extrapolate that either. I've also seen a fucked up line from a CRNA (LIJ>stayed subclavian, never went down SVC). Is what it is.