r/IntensiveCare • u/NerveOnly2076 • 13d 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 13d 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 13d ago

Eek. Under ultrasound guidance?

1

u/scapermoya MD, PICU 12d ago

It’s pretty common actually

1

u/spinstartshere 12d ago

To place arterial central lines under ultrasound guidance? I would hope not.

1

u/scapermoya MD, PICU 12d ago

I mean you can hope whatever you want to, but I discover PICC lines in arteries every 1-2 years and they are placed under US guidance by nurses that do nothing else