Virtual Pediatric Hospital(tm) : A digital library of pediatric information

Home | Search | About Us | FAQ | Reviews | Contact Us
Additional pediatric resources: SearchingPediatrics.com | Pediatric Commons Facebook iconTwitter iconRSS icon | PediatricEducation.org | GeneralPediatrics.com

Virtual Pediatric Hospital: Paediapaedia: Approach to Proper Positions for Tubes and Lines Paediapaedia: Neonatal Chest Clinical and Radiographic Presentations, DDX, Approach to Imaging

Approach to Proper Positions for Tubes and Lines

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


DDX:
Not applicable

Approach/Discussion:
Umbilical Arterial Catheter (UAC) Hi Positioning - Courses to left side of spine on the AP film and posteriorly on lateral film. The tip projects between T4 (ductus arteriosus) and T10/11 (celiac axis).

Umbilical Venous Catheter (UVC) - Courses to right side of spine on the AP film and anteriorly on lateral film. The tip projects over right atrium. The UVC courses from umbilical vein to left portal vein to ductus venosus to either hepatic vein or IVC and then into right atrium. The UVC tip should not be within the liver or the right atrium.

Central Venous Line (CVL) - tip in superior vena cava

Endotracheal Tube (ETT) - Below the thoracic inlet and above the carina. The ETT shifts with head position. As the head is flexed forward the ETT appears to lie lower in the trachea than it does, and as the head is extended posteriorly the ETT appears to lie higher in the trachea than it does.icon gif

ECMO arterial-venous (AV) - The tip of the arterial catheter should be in the aortic arch and the tip of the venous catheter should be in the right atrium. The exact position of these tips may be difficult to determine as they are often not radiopaque.icon gif

ECMO venous-venous (VV) - The tip of the venous catheter should be in the right atrium pointing towards the tricuspid valve. The exact position of this tip may be difficult to determine as it is often not radiopaque.icon gif

Levels of the Vascular Axes

Aortic Arch - T4

Celiac axis - T10-T11

SMA - T11

Renal arteries - T12-L1

IMA - L1

Iliac bifurcation - L3

References:
See References Chapter.

Section Top | Title Page


Additional pediatric resources: SearchingPediatrics.com | Pediatric Commons Facebook iconTwitter iconRSS icon | PediatricEducation.org | GeneralPediatrics.com
Home | Search | About Us | FAQ | Reviews | Contact Us

Virtual Pediatric Hospital is curated by Donna M. D'Alessandro, M.D. [Google+ Profile] and by Michael P. D'Alessandro, M.D.

Please send us comments by filling out our Comment Form.

All contents copyright 1992-2014 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.

"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.

Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.

Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.

The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.

URL: http://www.virtualpediatrichospital.org/

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.