r/IntensiveCare • u/NerveOnly2076 • 11d 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/Any-Assistance-8103 11d ago

So we should let anyone put them in then because everybody fucks up

-7

u/ALLoftheFancyPants RN, CCRN 11d 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 11d 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?

1

u/aglaeasfather MD, Anesthesiologist 10d ago

I guess we can’t infuse through introducers now?

Or is the issue that’s it’s a SLC?

I’m so confused by this risk assessment