Ultrasound Confirmation of Central Line Placement May Make Chest X-Ray Obsolete

Ultrasound can be used to visualize injected saline, localize the catheter tip, and detect pneumothorax.

Investigators compared ultrasound to chest x-ray for confirmation of placement of supradiaphragmatic central lines and to rule out pneumothorax in 46 emergency department patients. Correct placement was confirmed by visualization of microbubbles in the right atrium immediately after saline injection into the distal port. Pneumothorax was ruled out by presence of normal lung sliding.

Average time for the ultrasound exam was 5 minutes versus 28 minutes to perform the chest x-ray and 299 minutes for a radiologist's interpretation (time to interpretation by the clinician was not reported). There were three misplaced lines and two pneumothoraces. Residents performing the ultrasound studies failed to detect two of the three misplaced lines, but su…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Ultrasound Confirmation of Central Line Placement May Make Chest X-Ray Obsolete

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Reviewing Author