Question

Explain the impact of poor patient positioning upon the visualization of proper line or tube placement accuracy. Provide examples.

Answer 1

Placement of lines and tubes are indicated in variety of patients. placement of venous and arterial lines are common procedures and indicated in following conditions:

1. drug infusion

2. central venous pressure monitoring

3. access to the veins and arteries

4. fluid resuscitations

5. Mean arterial pressure measurement

6. taking samples for ABG analysis and other blood tests.
Many types of procedures are carried out for insertion of tube into the body. A feeding tube is inserted into gastrointestinal tract for feeding and providing nutrition to the patient. Chest tube helps to drain fluid from lungs. A nasogastric tube is used to deliver drugs and food and nasal aspirations. Urinary catheters are used to drain the urine from the bladder.

Placement of tubes and lines requires a great skill and use of proper technique. Misplacement of lines and tubes can to lead to blood vessel injury, incorrect measuring of vitals, venous infusions, line stenosis and blockage, injury to the organs.
The correct positioning of the patient plays a great part in the proper and correct placement of lines and tubes. Correct and comfortable positioning of the patient helps in easy access of the anatomical structures. It also helps in proper visualisation during the procedure without hindering the view. This helps in correct placement of tubes and lines. failure to place lines and tubes correctly demands for repetition of procedure and placement of new lines and tubes which increases the risk of infections.
For example placement of  central venous line include patient placed in supine with lowering of head. This helps in easy access to the veins as the gravity assists the venous filling which makes veins engorged.This makes venous puncture easier.