Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 01 May 2020

Unique Cases of Intracavitary-Electrocardiogram Success in the Pediatric Intensive Care Unit: Jump Aboard, Innovators!

RN, CPNP-AC, FCCM,
RN, CPNP-AC,
RN, CPNP-AC,
MD, and
MD
Page Range: 44 – 47
DOI: 10.2309/JAVA-D-20-00002
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Highlights

  • Intracavitary ECG is well supported in the adult and pediatric literature.

  • Most pediatric institutions have been slow to adopt IC-ECG.

  • With IC-ECG the use of a chest radiograph for PICC placement is unnecessary.

Abstract

Proper peripherally inserted central catheter (PICC) placement has traditionally been confirmed by the use of a chest radiograph. With the innovation of the intracavitary electrocardiogram (IC-ECG), the use of a routine chest radiograph is not indicated. However, in many pediatric centers a chest radiograph is still required by policy. This article describes 4 cases in which PICC lines were properly placed using IC-ECG and the routine chest radiograph was unable to locate the PICC tip position.

Keywords: PICC; intracavitary ECG; pediatric; intensive care
Copyright: Copyright © 2020 Association for Vascular Access. All rights reserved.
Figure 1.
Figure 1.

Female 18 years old with left basilic PICC tip obscured by spinal rods. PICC = peripherally inserted central catheter.

Figure 2.
Figure 2.

Male 19 years old with right basilic PICC tip obscured by subcutaneous emphysema. PICC = peripherally inserted central catheter.

Figure 3.
Figure 3.

Female 22 years old with left basilic PICC tip obscured by spinal rods. PICC = peripherally inserted central catheter.

Figure 4.
Figure 4.

Female 25 years old with right brachiocephalic CICC tip obscured by spinal rods. CICC = centrally inserted central catheter.

Contributor Notes

Correspondence concerning this article should be addressed to weberm@email.chop.edu
Received: 10 Jan 2020
Accepted: 17 Mar 2020
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