I work at very large teaching, level one trauma center and there are a few practices that I have questioned in regards to lines.
First one is, two Mac or cordis (introducter) lines inserted into the same IJ during liver cases. I understand the rationale for big access in these cases as they require tons of transfusions. My concern is two 9 fr catheters in one vessel, does any one else see this as a problem. I asked an anesthesia resident and he said because it's easier to do 2 sticks on One prepped site rather than cleaning another... Seems more of a convenience than anything. He also rationalized it as the vessels can expand to accommodate this.
Second, I've seen anesthesia residents and even fellows change art lines over wires to the long femoral arterial lines in a radial artery! Again my concern is that burden on a smaller vessel to hold a catheter that probably almost reaches the elbow. I asked one resident if this was "ok" and his response was probably not.
What do you think?