Catheter Tip Location & Verification Flashcards

During CVC insertion, blood return is bright red and pulsatile. What is the most appropriate next step?

Answer: Confirm arterial placement with pressure transduction or blood gas analysis before use

Suspected arterial placement must be confirmed by transduction or blood gas before any infusion.

Why is blood color alone unreliable for ruling out arterial cannulation?

Answer: Hypoxemic or shocked patients may have dark arterial blood

In hypoxia, arterial blood can look dark and be mistaken for venous blood.

On a lateral chest film, a CVC tip curves posteriorly at the level of the carina. Where is the tip most likely located?

Answer: Azygos vein

The azygos vein enters the posterior SVC at about the level of the carina, so a tip there curves backward.

Which action can cause PICC tip migration after placement?

Answer: Forceful coughing or vomiting

Sudden rises in intrathoracic pressure from coughing or vomiting can move the catheter tip.

How does upper arm position affect the tip of a PICC placed in the basilic vein?

Answer: Adducting the arm can move the tip deeper by several centimeters

Moving the arm can shift a PICC tip by 2 cm or more, and adduction usually advances it centrally.

Which finding at a routine PICC assessment most strongly suggests tip migration?

Answer: An increase in the external catheter length compared with the insertion record

A change in external length from the documented baseline means the catheter has moved.

What should be documented after tip location is confirmed?

Answer: Verification method, tip location, and external catheter length

Documenting the confirmation method, tip position, and external length gives a baseline for later checks.