Every now and then a TTE or TEE report will show the tip of a PICC in the right atrium despite being verified previously at CAJ per Chest X-ray. The last time that happened the attending MD asked me to pull it back 3 cm. I did and the Chest X-ray following showed it to be mid SVC. I was not happy about that. Same thing this week so I showed X-ray and Echo report to interventional radiologist who told me to not pull it back as pt's MD requested. 4Fr single lumen PICC for long term antibiotics at home. Why do PICC's show up in atrium on TTE but appear to be well placed on Chest X-ray?
Rodney Allen RN
Houston, Texas
You have identified the limitations of conventional chest xrays as they do not reveal the exact venous location. You are assessing tip location of a 3D person based on anatomical landmarks as seen on a 2D film. Also, arm movement will cause the PICC to move. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861