39 yo female was admitted to the hospital with a diabetic foot ulcer. She needed IV access for Unasyn IV and labs, and failed several peripheral line attempts.
A right IJ central line was placed. Immediately after the catheter was placed, she complained of SOB(dyspnea) and palpitations. Her SpO2 was 100%, breath sounds were equal and clear bilaterally.
What do you think is going on?
Is it a pneumothorax?
HR was 140 and irregular.
EKG showed AFib with RVR.(rapid ventricular respons) CXR showed that the triple lumen catheter (TLC) was at the level of the right AV junction.
TLC at the right AV junction on CXR
AFib due to a TLC at AV junction
What would you do?
Withdraw the central line. Repeat the CXR and EKG.
What happened?
The TLC was withdrawn 5 cm with conversion to sinus rhythm and no further complaints.
Central line in superior vena cava (SVC). This is the correct position for a TLC on CXR.
Conversion to NSR(normal sinus rhythm) after the TLC was repositioned
What your final Diagnosis????
correct diagnosis will answer on 26.11.2008
write your full diagnosis on discussion below k..
tq..
