Central lines in all the wrong places

[HankReardon]

I did 2 femoral CVCs and 1 radial a-line successfully in med school. However, on my 2nd day of residency and first attempt at a line I put the needle into the femoral artery (I didn't dilate but everyone had a good laugh at the arterial pumping). The RN held pressure while I successfully placed one on the other side. Next I moved to the arterial line which ai proceeded to plug straight into a vein. I told the supervising senior it looked like the wrong color and seemed kind of deep but she convinced that there was no waveform to the oozing blood and that there isn't another vessel large enough in the area to cannulate. There is, of course - the radial vein... which would seem kind of deep...l

Fun thread.

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[e30ftw]

in the unit currently.. called to ED for a septic pt. looked at CXR showing R SC CVL going into R IJ.. while levophed/meds maxed out pumping up into the IJ (tip terminated above angle/mandible.. )

found out later one of my residency colleagues placed the line, knew it was going the wrong way but rather than fix it just left pressors going and left the line for ICU to fix so he could go home early.

wtf man way to represent EM. I ended up just placing an IJ after trying to reposition the line but thought that was poor form. pt probably fine but rubbed me the wrong way to just bounce rather than fixing the line that you placed. Of course I understand time constraints, etc, leaving the azygous line in, etc, but this was a "my shift is ending soon and i wanna leave so i'm not fixing it" type of situation.

 

[Bostonredsox]

I do not allow any of my interns or any other member of our team to leave the hospital until the xray THEY ordered for the line THEY put in has been reviewed and Ok'd by THEM to use. Your line, your responsibility, your complications. I have personally waited >30 minutes past shift end for a line I did as a favor to one of the hospitalists, for a fat lazy xray tech to come up and shoot a film then trudge her a** back down and load the film for me to see. I did not trust the hospitalist to look at it before Ok'ing it nor that he would be able to fix any complication of it.

YOUR line, YOUR responsibility.