Internal jugular line - misplaced

Case contributed by Andrew Kirby

Presentation

Has been on ITU for 1 week following unresponsive episode. Reduced oxygen saturations today.

Patient Data

Age: 70 years
Gender: Female

Left internal jugular line is misplaced - it courses upwards rather than down towards central thoracic veins, and is likely within upper IJV.

Right internal jugular line and endotracheal tubes are appropriately placed.

Left retrocardiac airspace consolidation is present with obscuration of the left diaphragmatic border, indicating left lower lobe consolidation.

Case Discussion

This case highlights the importance of reviewing external lines and tubes. Prompt feedback of malpositioned tubes to the attending team is vital.

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