"Venous thrombosis is a potential postplacement complicationof a central venous access device (VAD). Improper catheter tip positionis a predisposing factor, especially when the device is usedto administer parenteral nutrition (PN)."
Journal of Parenteral and Enteral Nutrition, Vol. 31, No. 5 2007 382-287 DeChicco et. al.
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and then clips from posts from other 'posters' on this forum................
Dierks, M and E Whitman, Catheter tip position in the analysis of central venous access devises outcomes. Journal of Vascular Access Devises, 1995. 1(3): p 11-14
1. Vesely T. Central venous catheter tip position: A continuing controversy. Journal of Vascular and Interventional Radiology. 2003;14:527-534. 2. Vesely T. Optimal positioning of central venous catheters. Journal of Vascular Access Devices. 2002;7(3):9-12.
Spring 2008 JAVA there is an article by Peter Verhey
Mari Cordes, BS RN
Nurse Educator IV Therapy
Fletcher Allen Health Care, Burlington VT
Educator, Bard Access Systems
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center
Positions from professional organizations:
INS 20006 Lower one third to caj
FDA CVC Working Group 1989, 1994 lower one third
AVA 1998
ONS 2004
NKF/DOQU 2001
SIR 2003
2. Vesely T. Optimal positioning of central venous catheters. Journal of Vascular Access Devices. 2002;7(3):9-12.
Mari Cordes, BS RN
Mari Cordes, BS RNIII VA-BC
Vascular Access Department
University of Vermont Medical Center