Do you have specific cm parameters for when to require a new CXR if the line is re-inserted or pulled back at time of placement? Or if pulled out during dressing changes?
Considering the anatomy of the SVC/RA, my opinion is that you only have 2-3 cm to work with. The SVC is about 7 cm in length. So 3 cm pulled out would put the tip at the mid-SVC if the original tip was located directly at the CAJ. Anything more than that would increase the risk of tip migration, impingement on the vessel wall and increased risk of thrombosis. I have never seen any studies actually examining this issue though. Lynn
Considering the anatomy of the SVC/RA, my opinion is that you only have 2-3 cm to work with. The SVC is about 7 cm in length. So 3 cm pulled out would put the tip at the mid-SVC if the original tip was located directly at the CAJ. Anything more than that would increase the risk of tip migration, impingement on the vessel wall and increased risk of thrombosis. I have never seen any studies actually examining this issue though. 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