Central Venous Catheter Tip Placement: Determination of Posterior Malposition—A Case Study

Methods for determining central venous catheter (CVC) tip placement vary among facilities. In most institutions, a single-view, anterior chest radiograph is used to visualize and evaluate the CVC catheterfor malposition and/or position of the catheter tip. However, this method does not identify the posterior malposition of the catheter tip, which, on the anterior view, may appear correctly placed. In this article, the author (a) identifies the needfor double-view chest radiographs for accurate determination of CVC tip placement and (b) emphasizes the importance of expertise of vascular access practitioners in the determination of catheter-tip placement and the identification of malposition and complication of CVC placement.