Catheter Tip Location & Verification Flashcards

On a neonatal radiograph, where is the ideal tip location for an umbilical venous catheter?

Answer: At the IVC–right atrial junction, about T8–T9

A UVC tip should sit at the junction of the IVC and right atrium, usually projecting at T8–T9.

A high-position umbilical arterial catheter tip should project at which vertebral level?

Answer: T6–T9

High UAC placement is T6–T9, above the celiac, mesenteric, and renal arteries.

During ultrasound-guided CVC placement, what does the rapid atrial swirl sign confirm?

Answer: The tip is central: saline contrast shows turbulence in the right atrium within about 2 seconds

Seeing agitated saline swirl in the right atrium almost right after a flush supports central venous tip placement.

In general, when may a newly placed CVAD be used before tip location is confirmed?

Answer: Only in an emergency where the benefit outweighs the risk

Tip location should be confirmed before use, except in emergencies.

Which patient condition would make ECG-guided tip confirmation unreliable?

Answer: A permanent ventricular-paced rhythm without visible P waves

Paced rhythms without visible P waves prevent P-wave interpretation.

A chest x-ray shows a right-arm PICC tip crossing midline into the left brachiocephalic vein. What is the correct action?

Answer: Report the malposition and arrange repositioning before using it as a central line

A tip in the contralateral brachiocephalic vein is not central, so it must be repositioned before central infusions.

For an implanted chest port, where should the catheter tip be located?

Answer: At or near the cavoatrial junction

Like other CVADs, a port catheter tip should be at the cavoatrial junction.