Forum topic

Any catheter that is located distal to the lower portion of the SVC is no longer a central venous catheter. There is what has come to be known as the midclavicular tip location which is in the subclavian-axillary vein. And then there is the midline tip location which is in the basilic or cephalic vein of the upper arm level with the axilla but not crossing the shoulder. You will need to read the INS standard of practice, the AVA tip position paper and a recent article in the last issue of JIN on the issue of midclavicular in addition to the article already mentioned. What you are doing is a dangerous practice that increases the risk of catheter-related vein thrombosis and therefore increases your legal liabililty. You should locate all these resources and work toward changing this practice. Lynn