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Images in neonatal medicine
Real-time point-of-care ultrasound-guided correction of PICC line placement by external manipulation of the upper extremity
  1. Jeffrey Vincent Suell1,
  2. Malorie Meshkati1,
  3. Courtney Juliano1,
  4. Alan Groves2
  1. 1 Icahn School of Medicine at Mount Sinai, Department of Newborn Medicine, New York City, New York, USA
  2. 2 Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
  1. Correspondence to Dr Jeffrey Vincent Suell, Newborn Medicine, Mount Sinai Medical Center, New York, NY 10019, USA; jeffrey.suell{at}mountsinai.org

https://doi.org/10.1136/archdischild-2019-317610

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    A 2.0 kg early-term infant with congenital heart disease required central venous catheter placement for persistent hypoglycaemia. A 1-French peripherally inserted central catheter (PICC) was placed in the basilic vein of the left forearm and advanced to 13 cm, commensurate with expected appropriate depth given preprocedural measurements. Point-of-care ultrasound (POCUS) was used to confirm catheter location,1 with X-ray for verification. Initial POCUS and X-ray revealed that the catheter was directed superiorly into the left internal jugular vein (figure 1A,B).

    Figure 1

    Ultrasound and chest …

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    Footnotes

    • Contributors JVS: conceived of study and drafted initial text and placed peripherally inserted central catheter (PICC) line. AG: performed point-of-care ultrasound. MM: service fellow, assisted with manipulation of arm and edited drafts. CJ: neonatal attending who edited final version of text and approved for publication.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Parental/guardian consent obtained.