Slide 1: What are the labeled objects on these radiographs?

Slide 2: These are all forms of central venous access! Radiograph in the top left: non-tunneled central venous catheter (CVC). Radiograph in the top right: tunneled central venous catheter (CVC). Radiograph in the bottom left: Peripherally inserted central catheter (PICC). Radiograph in the bottom right: implantable port.

Slide 3: What is the correct positioning of these lines? Ideal positioning of the catheter tip for central venous access is at or just above the cavo-atrial junction. This can be located two vertebral bodies below the carina on a chest radiograph.

Radiograph on the left. Short term, non-tunneled catheters can be placed in the SVC. They should be at most 1.5 cm above the carina.

Radiograph on the right. Hemodialysis catheters are ideally placed with the tip just past the cavo-atrial junction in the right atrium due to the high flow rate through the catheter.

Slide 4: What doe we use these lines for?

Line. Non-tunneled CVC. Purpose. Medications. vasopressors, hypertonic solutions, irritant mediations, inotropes. Short term parenteral nutrition. Short term hemodialysis and apheresis. Duration. Short term (days to weeks).

Line. PICC. Purpose. Complicated IV access. Outpatient access. e.g. antibiotics, chemotherapy, parenteral nutrition. Duration. Medium term (weeks to months).

Line. Tunneled CVC. Purpose. Hemodialysis (most common), chemotherapy, parenteral nutrition, apheresis. Duration. Long term (months to years).

Line. Port. Purpose. Most commonly for chemotherapy. Duration. Long term (months to years).

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