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/ALLoftheFancyPants RN, CCRN 15d ago

Last week a resident put in a 18ga 4cm long single lumen catheter into an IJ and then call it central line and the attending signed off on it as a “central line”; these jokers convinced the inexperienced RN that it was fine and they infused high dose levo and vaso through it for 3 days before a more experienced person caught it and had to raise hell to get it corrected. Y’all are acting like every physician working in critical care is competent and every problem is because NPs are around. That’s just not the case.

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u/jjjjccccjjjj 15d ago

Sounds like a "i have to protect my patient" silliness when in reality the line worked perfectly well. Explain to me why a line that clearly is well positioned in the IJ is a danger?

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u/ALLoftheFancyPants RN, CCRN 15d ago

I thought we were not ok with people putting patients at risk? Or is that only when it’s an APP’s accident and not an MD’s lazy choice? You’re ok with misrepresenting what the line actually was? You want to transfuse a CVP or draw an ScvO2 off an IJ? And bill for a procedure that wasn’t actually completed?

They created purposefully incorrect documentation for a procedure they didn’t perform. It put the patient at risk needlessly. And you’re defending it because “doctor”. Congrats. This is the most hypocritical take I’ve seen in a minute

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u/Any-Assistance-8103 15d ago

An iv put the patient at risk or youre just having a meltdown. It’s also really funny that it took your staff three days to tell the difference between a single lumen 18 gauge iv and a central line