Case: A 68 year old woman presents to the ED with fever, hypotension, and AMS. She has a PICC in place. Your overzealous intern places a central line, and he swears the stick was venous. You obtain and CXR to confirm line placement.

Where does the line terminate?
A. The intern is a liar, it's in the arterial system. Call IR
B. It is in the venous system but extends to the right brachiocephalic vein.
C. It is in the lung. Call CT surgery.
D. It is placed appropriately terminating in the SVC.

ANSWER