Using Agitated Saline and Point-of-Care Ultrasound to Confirm Central Venous Catheter Placement: A Quality Improvement Project by Advanced Practice Providers

Abstract

Central lines placed in the internal jugular or subclavian vein are common among critically ill patients. A chest x-ray serves as the confirmation method in many institutions. However, ultrasound with agitated saline has been proven an effective, faster, and safer alternative. Visualizing microbubbles in the right atrium within 2 seconds can confirm correct placement. This quality improvement project describes the training and competency evaluation of advanced practice providers in using agitated saline with point-of-care ultrasound to confirm central venous catheter placement. Sharing our experience and data may encourage others to implement similar quality improvement efforts.