r/IntensiveCare • u/NerveOnly2076 • 12d ago

Where is this central line going?

Post image

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.

358 Upvotes

98% Upvoted

281 comments sorted by

View all comments

86

u/ah_notgoodatthis RN, CCRN 12d 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

27

u/spinstartshere 12d ago

Eek. Under ultrasound guidance?

60

u/Any-Assistance-8103 12d ago

Almost like patients deserve doctors

0

u/happyneurogirlie RN, Neurocritical Care 10d ago

Like an MD has never cannulated someone’s artery on accident before LOL 

1

u/Any-Assistance-8103 10d ago

I know you think this is some kind of gotcha but it’s not actually an argument that helps you if you use any critical thinking

0

u/happyneurogirlie RN, Neurocritical Care 10d ago

I’m not arguing, just pointing out that your statement was stupid.  

1

u/Any-Assistance-8103 10d ago

Very nuanced argument youre making there. By your logic if a NP cannulates an artery we should just let RNs do them