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Peds Tubes and Lines

UVC

Course: Umbilicus → Umbilical vein → Left portal vein → crossing into Ductus Venosus → into IVC at confluence of hepatic veins → terminates at cavo-atrial junction (just above or at right hemi-diaphragm)

Displacement: right and left portal vein, SMV, splenic vein, hepatic veins, SVC, IJV, left atrium (by PFO)


UAC

Course: Umbilicus → Umbilical artery → Internal iliac artery → Common iliac a. → Aorta. 2 acceptable tip positions:

  • high T8-T10
  • low L3-L4
to avoid placement near important aortic branches
  • Coeliac truncus: T10-T12
  • SMA: T12-L1
  • Renal arteries: L1-L2
  • IMA: L2-L3

ETT

The tip of ETT should be placed in mid-thoracic trachea at C7-T2 level above the carina

Right main stem intubation occurs more frequently because of its more direct course from the trachea


Chest Tube

Positon (posteriorly, anteriorly). Position of the side holes


NG Tube

Can go to right lung through main stem bronchus. Can perforate esophagus. Can diagnose esophageal atresia. Serves for decompression, not feeding


Naso-Jejunal Tube

Complications: perforation, kinks and intussusception