I am being told by the medical director/administrator that I must get a CXR after inserting an internal jugular CVL post induction before I can use it. I have only recently moved to this rural Australian hospital. My normal practice is to place the CVL post induction using Ultrasound guidance with the head midline and feel the guidewire down. I usually look for evidence of atrial stimulation to check I'm in the RA. I aspirate venous blood after removing the guidewire. I then measure the distance to the sternomanubrial junction using the marks on the guidewire then position the catheter to that length.
I used to do cardiac anaesthesia as well as Intensive CAre and have placed at least 1500 catheters this way. They get a post op CXR.
Does anybody do an on-table CXR before using an Internal jugular CVL place post induction?