CVLs: When gas is useful in #POCUS

Here are 2 studies that Tom Jelic presented at the latest EDE 3 journal club looking at the use of a saline flush to confirm central line placement. In the presentation, Tom shows a video of a subxiphoid view showing what is seen within 2 seconds of the flush being injected. The 2 studies were led by Weekes from Charlotte and Duran-Gohring from Jacksonville.

This is a point that came up in the discussion. If a subclavian line inadvertently gets fed up the internal jugular, you might still get a flush in the right side of the heart. But there will be a few second delay in that flush appearing. Also, if you are uncertain, you can use EDE to look for the catheter in the IJ. Pretty easy stuff!