We've recently had two docs refuse to order x-rays for tip placement when they inserted femoral lines-which
they called "central lines" and the nurses were expected to use as central lines. Â Our nursing policy follows INS
Standards which say a femorally inserted central line must have the tip in the IVC above the diaphragm.
 These docs said "there's no where else the catheter can go". Â
Does anyone else have a policy regarding femorally placed CL's--their tip termination?
Thanks,
Tanya
IV Support/Educator
SHMC
Eugene, OR
We have found this to be true also. The doctors don't need xrays and it is a "central line".
In our pediatric patients, I looked at the patients with DVTs over a 16 month period to determine if the DVTs were related to PICCs. What I found was not what the physicians expected. They believed that the DVT rate was high with PICCs.
The patients had PICCs to treat their DVTs. The largest percentage of the DVTs were in veins associated with femoral "central lines" that the patient had. Locations like iliac, portal, etc.
Based on that there have been some pediatric physician practice changes, but still femoral lines are used like "central lines", in spite of the tip location, for pediatric and for adults.
I will be watching for others comments.
Gwen Irwin