Right Tip Position

This chapter provides insight into intravenous catheter tip location and review of vascular access devices from PIVC to central venous non-tunnelled and tunnelled catheters, implanted ports and dialysis catheters. An overview of the guidelines related to tip location is discussed. The dynamic relationship between catheter tip location and how this influences complications during the procedure and post-insertion is examined. The various methods of confirming Central venous access devices (CVAD) tip location are presented, including ECG (i.e. echocardiography) versus traditional means of X-ray, exploring patient implications of intraprocedural real-time tip location, reduced radiation dosage and incidence of manipulations. Case studies illustrating some of the challenges clinicians face when placing CVADs are incorporated into the discussion.