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While I will probably get stoned for heresy by the medical community---INS
Standard 43 states in part, "...Central catheters should have the distal
tip dwelling in the vena cava.."
The wisdom of this statement is not lost in practice. I heard from a
colleague that a patient
was admitted to an acute care facility with an allegedly femoral vein
catheter that when xrayed was found to be in the femoral artery--there had been
no xray done at placement or on admission. I try and insist that a
placement film be done when I know about these lines
and doctors usually accommodate by ordering the film-whether the device is
placed in the
chest, neck, or the groin. Since we all know that TPN is far
from isotonic-it should be infused through a central line. Best
regards-Kathy Mohn
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