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CVC Tip Position — FRCA Final MCQ

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EasyAnaesthetic Equipment & SafetyCVC Tip PositionFRCA Final

A 50-year-old man (ASA III) has a right internal jugular central venous catheter placed for TPN. A post-procedure chest X-ray shows the tip at the junction of the SVC and right atrium. Is this position acceptable?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Yes – this is the ideal position

The ideal CVC tip position for general use (including TPN) is at the SVC-right atrial junction, confirmed by chest X-ray. The carina on CXR approximates the SVC-RA junction. A tip positioned too proximally (in SVC or brachiocephalic vein) risks vessel wall erosion and extravasation. A tip too distally (in the RA or RV) risks arrhythmias, tricuspid valve injury, and cardiac perforation/tamponade. For haemodialysis catheters, the tip is positioned in the upper right atrium to achieve adequate flow rates.

Reference: NICE – 2017 – CG139 Healthcare-associated infections; RCOA – 2023 – Vascular access module