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Introduction: Lines & Tubes

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Oftentimes, you'll get radiographs or imaging looking for

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line and tube placement, which is very common in the ED.

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So common lines

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you're going to see are endotracheal tubes, enteric tubes,

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chest tubes, PICC lines, tracheostomy tubes,

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Central Venous Catheters.

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Usually, these are initially evaluated by radiographs,

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and it's usually as a single portable radiograph

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is being done.

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However, sometimes the lateral is very helpful for actual

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placement in the anterior-posterior plane

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which you're not necessarily going to appreciate

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just on a single PA view or an AP view.

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Oftentimes, a chest CT may reveal,

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again, much more specific placement

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if the patient is imaged for other reasons, but you always

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want to make sure that you're looking for the line

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and tube placement, both on the CT,

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and try to make an estimate as best you can

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on the radiograph.

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So, keep in mind that when you're looking at the

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endotracheal tube depth, that changes with head position.

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So when possible, keep in mind where the head is, and you

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can look for the soft tissue shadows,

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whether or not they're flexed or extended because that is

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going to move the endotracheal tube position

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and you want to be able to interpret that in context.

Report

Faculty

Jamlik-Omari Johnson, MD, FASER

Chair, Department of Radiology

University of Southern California

Tags

Trauma

Pleural

Neoplastic

Lungs

Iatrogenic

Emergency

Chest

CT

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