Casey J. Schuller, RN, BSN, VA-BC: No financial relationships to disclose
Vascular access specialists placing central lines in all patient populations (neonate, pediatric, and adults) is certainly not the norm. Finding one ECG based tip confirmation system that could be utilized for all patient populations and any catheter size is important. This ECG tip location device is utilized with either a magnetic based stylet (allowing for navigation) or can be utilized with just an intracavitary ECG based saline column only (allowing for ECG tip confirmation) in any catheter size that is able to retain a saline column. This device allows the inserter to be aware of appropriate tip position in real-time, thus reducing primary malposition and radiation exposure due to multiple radiographs. This is especially important in the neonate and pediatric patient populations. Understanding that there are times when ECG cannot be utilized to replace radiograph for tip confirmation, the device will help reduce primary malpositions, thus reducing radiation exposure and decreasing delays in the initiation of IV therapy.
Learning Objectives:
Discuss the different types of central venous catheter tip confirmation techniques.
Describe the differences between navigation and confirmation during a central venous catheter placement.
Define appropriate central venous catheter tip location with placements in upper extremity (SVC) vs lower extremity (IVC).
List benefits to accurate tip placement of central venous catheter on the initial attempt.
Discuss your current practice for tip location and potential for change.
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