Ask Dr. Z

How would you report the following central venous access procedure? Would this be central or peripheral due to temporal access? Also, why might the provider consider this unsuccessful if the tip terminates in the SVC? "Central Line Procedure Note. Patient Age: 7-weeks-old. PICC - PEDIATRICS. The patient was positioned supine. This procedure was performed under sterile conditions. The catheter was cut to cm. The 26 gauge catheter was inserted into the right temporal vein. We advanced the single lumen PICC catheter to cm at skin entry level and secured in place. All ports were flushed with saline at the end of the procedure. Blood return was noted. A sterile dressing was applied. Line placement was not successful. Tip location terminates in the inferior vena cava (line insertion unsuccessful). Ultrasound was not used during this procedure. Additional Details: Results: Line unsuccessful. Both right and left temporal veins accessed, but unable to pass the catheter. Recommend escalation of PICC line placement to IR."