A question for OR nurses

[JJFROG]

A family member recently had a brain tumor, a benign meningioma, removed and anesthesia place a central line. They obiviously had difficulty starting the line as there were 8 attempts on the R subclavian, 8 attempts on each jugular and it was eventually place on the L sublcavian after what appears to be 8 more sticks. Yes, I myself counted the stick marks, along with the attending Pulmonologist in the SICU. No chest x ray was done on him until after surgery when he went in to cardiac arrest. Surprise....he had bilateral pneumos! My theory is he was so acidotic from inadequate perfusion he arrested. My question is, do you normally get a chest xray after placing a central line in the OR? I am an ER nurse and we get the PCXR immediately after placing the line, what is the norm for the OR? Thank you.

[SFCardiacRN]

We just had a VERY unusual situation after a difficult central line placement on a CABG case. The post case SICU x-ray showed the swann-ganz had "knotted" in the ventricle. It looked like a pretzel! A repeat sternotomy was required to remove it.

[kidsrme]

Chest x-rays are the norm in our facility after central line placement. As to the question of why insert a central line prior to removal of a brain tumor, I have a few thoughts. In our facility each patient undergoing any crani for tumor gets a central line for two reasons. First to rapidly replace blood loss should severe bleeding occur and secondly to allow for aspiration of potential air emboli during surgery.Whether this was the case I am unclear, but it may help to give reason as to why one 18ga peripheral IV was thought to be inadequate.

Kidsrme

[SFCardiacRN]

Central lines using a Swann-Ganz catheter measure central venous pressure, Pulmonary artery wedge pressure(right side heart function), as well as triple lumen for drips & bolus'.