Imaging of Lines and Tubes

The emergency room has evolved over the years, and the practice has become increasingly complicated, commonly turning them into mini ICUs. During rapid assessment and stabilization of the patients in acute setting, there is often a need to intubate the respiratory failure patients and provide intravenous fluid during resuscitation. With the growing volume of septic patients managed in the ED, central venous pressure monitoring has become more commonplace. This has led to the ED physicians placing more central line than ever. In this controlled chaos environment, the physicians are frequently exposed to anatomic variations which can lead to errors in line placement. Since image guidance is not routinely used during placement, the line or an endotracheal tube can be commonly malpositioned. However, we rely heavily on radiology to help confirm that the line or tube is where it should be without inadvertent damage to the surrounding tissue.