Normal Cardiac Anatomy - Central Line Confirmation
Caption
After placing a central line, POCUS can be used to rapidly and accurately assess correct venous placement as well as exclusion of pneumothorax prior to confirmation via a CXR. Simply attach an agitated flush to the central line, get a good view of the right side of the heart (here we used the subxiphoid view) then flush rapidly. If you see bubbles pass from the right atrium to the right ventricle of the heart, you know you’re good to go. POCUS has a sensitivity of 86.8% and specificity of 100% for identifying correct central venous catheter placement. See our evidence atlas for more information. PMID: 28123616 If you placed this under direct visualization you know you aren’t likely to have caused a pneumothorax… but POCUS can rule that out too! (Look for lung sliding, lung point, B lines, and lung pulse.) Devki Joshi MS4 - SUNY Downstate Medical School, Dr. Matthew Riscinti and Dr. Isaac Gordon - Kings County Emergency Medicine