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    Invasive Devices On CXR

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    Laurensia Erlina Natalia
    This document provides guidelines for checking the positioning of commonly used invasive devices in intensive care units using chest x-rays. It lists the normal positions and potential complications for each device, including endotracheal tubes, tracheostomy tubes, central venous catheters, dialysis catheters, pulmonary artery catheters, chest tubes, intra-aortic balloon pumps, and nasogastric tubes. Exceptions to the guidelines require approval from medical staff and documentation in the patient's record. The poster is intended to help medical professionals correctly check and monitor the placement of devices using chest x-rays.

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    Download as PDF, TXT or read online from Scribd

    Invasive Devices On CXR

    Uploaded by

    Laurensia Erlina Natalia
    247 views1 page
    This document provides guidelines for checking the positioning of commonly used invasive devices in intensive care units using chest x-rays. It lists the normal positions and potential complications for each device, including endotracheal tubes, tracheostomy tubes, central venous catheters, dialysis catheters, pulmonary artery catheters, chest tubes, intra-aortic balloon pumps, and nasogastric tubes. Exceptions to the guidelines require approval from medical staff and documentation in the patient's record. The poster is intended to help medical professionals correctly check and monitor the placement of devices using chest x-rays.

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    Invasive Devices on CXR

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    Invasive Devices on CXR

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    This document provides guidelines for checking the positioning of commonly used invasive devices in intensive care units using chest x-rays. It lists the normal positions and potential complications for each device, including endotracheal tubes, tracheostomy tubes, central venous catheters, dialysis catheters, pulmonary artery catheters, chest tubes, intra-aortic balloon pumps, and nasogastric tubes. Exceptions to the guidelines require approval from medical staff and documentation in the patient's record. The poster is intended to help medical professionals correctly check and monitor the placement of devices using chest x-rays.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    247 views1 page

    Invasive Devices On CXR

    Uploaded by

    Laurensia Erlina Natalia
    This document provides guidelines for checking the positioning of commonly used invasive devices in intensive care units using chest x-rays. It lists the normal positions and potential complications for each device, including endotracheal tubes, tracheostomy tubes, central venous catheters, dialysis catheters, pulmonary artery catheters, chest tubes, intra-aortic balloon pumps, and nasogastric tubes. Exceptions to the guidelines require approval from medical staff and documentation in the patient's record. The poster is intended to help medical professionals correctly check and monitor the placement of devices using chest x-rays.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Checking Invasive Devices Using Chest X-Rays

    COMPLICATIONS EXCEPTIONS
    PURPOSE
    - Pneumothorax - It may be acceptable to leave lines or devices in
    This poster identifies acceptable positions on chest X-ray of commonly - New pleural effusion suggesting haemothorax other zones (i.e. in high risk patients and/or those
    used devices in Wellington ICU. Please use this to check that any device - Widened mediastinum with difficult vascular access)
    has been & remains correctly placed - Subcutaneous emphysema - Exceptions must be approved by medical staff &
    - Pneumomediastinum documented in the clinical record
    Endotracheal Tube
    - Tip about 3-4cm above the carina with the head in neutral position Normal CXR Zones for correct placement

    Tracheostomy Tube
    - Tip lies between one-half & two-thirds of distance from stoma to carina

    Central Venous Catheter


    - Line & tip should be parallel to SVC not perpendicular to the wall
    - Ideally in lower SVC before the RA = level of carina
    - If left IJV or subclavian, tip in either RA or upper SVC as long as not
    perpendicular & doesnt impinge on lateral wall of SVC

    Dialysis Catheter
    - Same as for central venous catheter.
    - Line & tip parallel to SVC, not perpendicular to the wall. Tip may be in the RA

    Pulmonary Artery Catheter Correct Positioning Incorrect Positioning


    - No kinks/coils/ knots in the RA or RV
    - No further than left or right main bronchus. Should not extend beyond the
    proximal interlobar pulmonary artery (within 2cm of the hilum)

    Chest Tube
    - Side holes medial to the inner margin of the ribs (within the pleural cavity)
    - Ideally apical for pneumothorax, basal for fluid drainage

    Intra-Aortic Balloon Pump (IABP)


    - Tip should be 2-3cm lower than the left subclavian artery between T2 & T4
    - Ideally at the carina or, at the lowest, between carina & left main bronchus
    - If tip > 5cm below the aortic arch, it is malpositioned

    Nasogastric Tube
    Colour Key: Endotracheal tube, central venous catheter, dialysis catheter, PA sheath, pulmonary artery
    - Tip within the stomach, beyond the cardia, below the diaphragm, via midline
    catheter, chest tube, IABP, nasogastric tube Adapted with permission from original CVICU poster by D Arroyo & A McKee

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