PICC Placement

Yes, sometimes those little buggers with end up in the Azyous vein which is not appropriate placement for a PICC since the Azygous vein is not "central" it;s like a bifurcation off the SVC. It looks like a check mark on the CXR. So yes, sometimes the PICC tip does end up in the Azygous vein and we have to readust is minimally to get it out of there and into the SVC.

Agree with the above....do not use it...call the PICC nurse....a simple power flush will often fix this problem but not always.....after an adjustment another CXR will be needed

Is the rad saying it is "in" the azoyous vein or "at the level"? It looks like they are saying "at". That's similair to saying at the level of the corina or at the level of T7 for example.
If this is the case, maybe you could explain that it gets confusing for the different nursing staff and ask that he/she stick with stating proximal SVC, mid-SVC, distal SVC or cavoatrial junction. (hopefully it is distal or RA/SVC junction of course)
Of course, if it has done that pesky checkmark-looking turn up the azyous then reposition as stated already.