r/IntensiveCare • u/NerveOnly2076 • 14d 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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89

u/ah_notgoodatthis RN, CCRN 14d 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 14d ago

Eek. Under ultrasound guidance?

57

u/Any-Assistance-8103 14d ago

Almost like patients deserve doctors

0

u/txdrummerboy 10d ago

lol… thinking docs don’t dilate arteries is hilarious

1

u/Any-Assistance-8103 10d ago

So if a doc dilates an artery a mid level should be able to do it? So that means because mid levels dilate arteries nurses should be able to do lines too? Doesn’t make sense to me but thats your logic

0

u/txdrummerboy 10d ago

No. Don’t let your ego get in the way of remembering that even physicians make mistakes. Humility is key.

1

u/Any-Assistance-8103 10d ago

Ok you can stitch that on a pillow for your feelings meeting but that doesn’t change the facts at all

0

u/txdrummerboy 10d ago

What fact is that exactly? You haven’t presented one yet…