Insertion of central venous catheters including peripherally inserted central catheters is a frequent and significant event for children. Unfortunately, timely administration of important medical therapies is frequently disrupted due to central venous catheter (CVC) complications which are often preventable and the result of lack of compliance with best practice. Best practice relating to central venous catheter tip position dictates that upper limb central venous catheter and peripherally inserted central catheter (PICC) tips should be placed in regions where blood flow is greatest and risk of complications such as thrombosis and occlusion are lowest. This interactive presentation will discuss the various modalities for catheter tip confirmation and combine research with clinical practice by using case studies to explore the challenges clinicians face to ensure accurate identification of central tip location, the potential complications associated with suboptimal catheter tip position, and the techniques to remedy displaced catheters.

Learning Objectives: At the conclusion of this session, participants will be able to:

• Understand the importance of accurate tip position in the overall context of central venous access device (CVAD) and outcomes.
• Define appropriate upper and lower limb CVAD tip position.
• Describe the pros and cons of tip confirmation technology to ensure accurate CVAD tip position.
• Understand the published literature including systematic review and meta-analysis in different patient populations and where relevant apply this to their own practice.
• Discuss common challenges during catheter insertion, and how to troubleshoot malpositioned tips.
• Describe complications associated with inappropriate CVAD tip position.

Contact Hours: 1
CRNI® RUs: 2