IC - ECG Tip Location vs Xray - Feedback From the Field
In this presentation, I will share personal experiences and discuss the complications related to mispositioned lines and how little things can lead to a misinterpretation of the chest x-rays for line confirmation.
Placing any central line where the tip terminates is critical as it could impact patient safety, reduce complications, reduce delays in treatments and save time for the whole team looking after the patient.
For many years the primary way to confirm the tip position has been performing a chest x-ray and following the anatomical landmarks to identify if the tip was sitting in the Superior Vena Cava (SVC). However, research and studies have shown that fewer complications occur further down the SVC. The IC- ECG technology allows clinicians to place the central lines at the optimal position, the Cavo Atrial Junction (CAJ).
A vascular access service looking to change practice for tip confirmation faces multiple barriers; the hardest is educating the multidisciplinary team. Commonly, using the landmarks and chest x-rays, the different Trust policies state that the central catheter's tip has to be within 3-5 cm below the Carina level, which should be the lower third of SVC, but every patient is different. When using the IC- ECG technology, the tip will appear, in most cases, more than 3-5cm below the carina level, and clinicians reviewing the x-rays report as lines too low and need to be pulled back.
In this presentation, I will share personal experiences and discuss the complications related to mispositioned lines and how little things can lead to a misinterpretation of the chest x-rays for line confirmation.