• Niraj Kumar, Ashutosh Kaushal, Dev Soni Kapil K Critical and Intensive Care, All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India., and Gaurav Singh Tomar.
• Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, Delhi, India.
• BMJ Case Rep. 2017 Jul 6; 2017.

AbstractCentral venous catheter (CVC) insertion is associated with many potential complications; malposition of the catheter is one of them. A chest X-ray is routinely done to detect the malposition of catheter, but sometimes it has been seen that X-ray is time-consuming and its accuracy is also low for determining the exact position of the catheter tip. In our case, an ultrasonography (USG)-guided CVC was placed into the right internal jugular vein of the patient. As there was no ECG change obtained during insertion of guidewire and catheter, malposition was suspected, which was easily detected by a novel USG-guided saline flush test. We present a case report where USG was used for detection of a misplaced CVC (from right internal jugular vein to right subclavian vein). With ultrasound, the location of the catheter tip can be confirmed in very less time compared with chest X-ray.© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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