Hi all, my new mentors
OK. I changed the thread 9/2/2013.
I thought the Azygos vein attached vena cava from the NOT not left.
Look at the other attached pic (azygos1). That is definitely Azygos.
The angle and course is different in the other pic.
Well, I withdrew the groshong 4 cm. Got scared. LOL
Malposition of the day. Inserted a right sided Groshong catheter ealier today. I had to leave before looking at the CXR. My PICC colleague texted this PIC to me (I tweeked it a little, still a bad phone photo).
The RAD told the nurse to withdraw the catheter 3,5 cm.
Suggestions/opinions?
Above Carina, right?
Where is the tip? It's like a 90 deg. turn to the left and then.
Why? Double Vena Cava?
I know; there is some other things going on there.
Patient is on bensylpenicillin (abx) and isotonic fluids
Guess I have to fix this tomorrow
Ill try go get a better PIC tomorrow
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Looks like azygous to me.
Looks like a weird angle with none of the usual landmarks for a chest xray. Lynn
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Azygos Placement...if the presumed landmarks are correct
I have seen many Azygos placements in this view. A Lateral would differently show its true course.
Tim Royer
It's in the azygos. You can power flush or even leave it and rexray the next day...they will often spontaneously correct themselves
Jack
Look above. I changed the thread
Nurse specialist ICU/ANE/PICC.
Dep. of Neurosurgery
Umea University Hospital/SWEDEN
I am a little confused. Are these from the same patient or 2 different ones? What happened to the original picture you posted? Lynn
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
OK. The firt pic (azygos2) is from the patient above. I withdrew the catheter 4cm (to the white line). Decent position.
The second pic (azygos1) is from another patient a couple of moths ago. I'm assuming Azgos vein in that case(?)
Radiology showed no interest in these malpositions. I guess I have to demand a new evaluation next time.
Nurse specialist ICU/ANE/PICC.
Dep. of Neurosurgery
Umea University Hospital/SWEDEN
The view of this x-ray is anterior-posterior. While the angle from this view looks like a sharp 90 degree turn, a side view (lateral) will give the view what path the catheter is doing. The catheter may be going sideways-azygos, backwards-posterior, or even maybe inside the SVC going towards the Cavo-atrial junction. I would recommend to your physician next time a lateral view. I, personally have seen all three of these with this angle. Also-this might be the only open vessel for this patient?