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Patti Jo Carruth
Central line tip placement

I would like some feedback regarding stating "correct catheter tip placement in the lower 1/3 of the SVC" into a nursing policy on central lines; I am receiving some pushback regarding "directing physician practice" by making this statement in the policy.  Any comments?  A list of references would be helpful, FDA, physician written articles, etc....also any exclusions for RA tip placement (ie dialysis catheters) that is accepted practice....

Thank you in advance!

Patti Jo Carruth RN, BSN, OCN, CRNI

The statement about proper

The statement about proper tip location is not exclusively derived from nursing literature to create this standard for tip location. It comes from numerous medical studies and articles, and has long been the recommended tip location from physicians. It is the recommended tip location submitted by all manufacturers to the FDA for product labeling. Here are 2 articles written by an interventional radiologist:

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.


Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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