We have a pediatric intensivist who has on more than one occasion placed a picc line where the tip is shown on cxr to be in the brachiocephalic. When questioned that the line is malpositioned he states that was his intended target. On further discussion he states that SVC tip placement in pediatrics is not required as it is in adults. I know of no literature that supports this and would think that positioning in the brachiocephalic would have the same risks for complications in the pedi population as it does in adults. I would apprecaite any input on this, particularly from those that work with this group of patients.