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    Rapid Fire Radiology Khan

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    Mairaj Khan
    The document discusses optimal positioning and complications for various medical devices and procedures including endotracheal tubes, central lines, nasogastric tubes, chest tubes, pacemakers, and implantable cardioverter defibrillators. Ideal positions are outlined along with potential complications from malposition or perforation that can result in infections, injuries to organs or blood vessels, or cardiac dysrhythmias. A variety of imaging examples are provided to illustrate proper positioning and complications.

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    Download as PPT, PDF, TXT or read online from Scribd

    Rapid Fire Radiology Khan

    Uploaded by

    Mairaj Khan
    62 views41 pages
    The document discusses optimal positioning and complications for various medical devices and procedures including endotracheal tubes, central lines, nasogastric tubes, chest tubes, pacemakers, and implantable cardioverter defibrillators. Ideal positions are outlined along with potential complications from malposition or perforation that can result in infections, injuries to organs or blood vessels, or cardiac dysrhythmias. A variety of imaging examples are provided to illustrate proper positioning and complications.

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    Rapid Fire Radiology Khan.ppt

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    The document discusses optimal positioning and complications for various medical devices and procedures including endotracheal tubes, central lines, nasogastric tubes, chest tubes, pacemakers, and implantable cardioverter defibrillators. Ideal positions are outlined along with potential complications from malposition or perforation that can result in infections, injuries to organs or blood vessels, or cardiac dysrhythmias. A variety of imaging examples are provided to illustrate proper positioning and complications.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    62 views41 pages

    Rapid Fire Radiology Khan

    Uploaded by

    Mairaj Khan
    The document discusses optimal positioning and complications for various medical devices and procedures including endotracheal tubes, central lines, nasogastric tubes, chest tubes, pacemakers, and implantable cardioverter defibrillators. Ideal positions are outlined along with potential complications from malposition or perforation that can result in infections, injuries to organs or blood vessels, or cardiac dysrhythmias. A variety of imaging examples are provided to illustrate proper positioning and complications.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 41

    Rapid Fire Radiology

    The Iatrogenic Foreign Body

    Department of Emergency Medicine


    Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 10555
    Optimal ETT Tube Positioning

    • 5 ± 2 cm above the carina


    • When the carina cannot be visualized the ideal position of
    ETT is in the middle third of trachea at T2 to T4 level
    Complications

    • insertion into bronchus (pneumonia/pulmonary


    contusion/pulmonary laceration)
    • pharyngeal or esophageal perforation
    Case courtesy of Dr Muneesh Sharma, Radiopaedia.org, rID: 10328
    Case courtesy of Dr Jayanth Keshavamurthy, Radiopaedia.org, rID: 56505
    Optimal Central Line Positioning

    Cavo-Atrial Junction:

    yellow arrow: two vertebral body levels


    below the level of the carina

    blue arrow: intersection of bronchus


    intermedius with superior right heart
    border

    red arrow: intersection of the superior


    right heart border with SVC contour
    Complications

    • insertion into right atrium or ventricle


    (non-bacterial thrombotic
    endocarditis / dysrhythmias /
    myocardial perforation)
    • mediastinal hematoma secondary to
    vessel perforation
    • pneumothorax
    • hemothorax
    • central line-associated bloodstream
    infection
    • deep venous thrombosis
    Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID: 29298
    Case courtesy of Dr Jayanth Keshavamurthy, Radiopaedia.org, rID: 43483
    Case courtesy of A.Prof Frank Gaillard, Radiopaedia.org, rID: 21694
    Optimal Nasogastric Tube Positioning

    Ideally, 10 cm beyond the gastroesophageal junction.


    Post-Pyloric Tubes

    Crosses Midline!!!
    Complications

    • insertion into trachea or bronchus (pneumonia/pulmonary contusion/pulmonary


    laceration)
    • pharyngeal or esophageal perforation
    Case courtesy of Dr Hani Salam, Radiopaedia.org, rID: 8904
    Chest Tube Positioning
    • intercostal tube tip lies between
    visceral and parietal pleura
    • anterosuperiorly to drain
    pneumothorax
    • posteroinferiorly to drain
    pleural effusion or hemothorax

    Complications:
    • placement into lung parenchyma,
    interlobar fissure or subcutaneous
    tissue
    • mediastinal or abdominal visceral
    trauma
    • re-expansion pulmonary edema
    Pacemakers/AICD

    • single chamber: electrode tip in


    right atrial appendage (atrial
    pacing) or right ventricular apex
    (ventricular pacing)
    • dual chamber: electrode tips in
    right atrium and right ventricular
    apex
    • biventricular: electrode tips in right
    atrium, right ventricle and coronary
    sinus
    • implantable converter defibrillator:
    electrode tip in apex of right
    ventricle
    Complications

    • lead malposition (dysrhythmias)


    • pneumothorax
    • myocardial perforation
    • lead fracture
    Guess the Device!!!
    Case courtesy of Dr Hein Els, Radiopaedia.org, rID: 30776
    BONUS

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