{
  "id": 209960,
  "title": "any doctor can explain how to decide cvc placement near the shoulder?",
  "url": "/competitions/ranzcr-clip-catheter-line-classification/discussion/209960",
  "author_name": "",
  "post_date": "2021-01-09T07:56:49.196197400Z",
  "votes": 12,
  "comment_count": 2,
  "views": 0,
  "content": "<p>how can we decide if the cvc placement is good at the shoulder?</p>\n<p><img src=\"https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F113660%2F37c8fa5cf85d6dea9bf2b385a56ad07a%2FSelection_131.png?generation=1610178975200419&amp;alt=media\" alt=\"\"></p>",
  "messages": [
    {
      "id": "1145526",
      "postDate": "01/09/2021 07:56:49",
      "content": "<p>how can we decide if the cvc placement is good at the shoulder?</p>\n<p><img src=\"https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F113660%2F37c8fa5cf85d6dea9bf2b385a56ad07a%2FSelection_131.png?generation=1610178975200419&amp;alt=media\" alt=\"\"></p>",
      "rawMarkdown": "how can we decide if the cvc placement is good at the shoulder?\n\n![](https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F113660%2F37c8fa5cf85d6dea9bf2b385a56ad07a%2FSelection_131.png?generation=1610178975200419&alt=media)",
      "votes": null
    },
    {
      "id": "1146100",
      "postDate": "01/09/2021 14:43:36",
      "content": "<p>Not a radiologist, but general rule of thumb - is the trajectory of CVC going a standard way - ideally CVC tip need to be placed in vena cava just before heart entrance.</p>\n<p>The borderline in this competition is defined 2 ways:</p>\n<ul>\n<li>the tip is just a little too deep optimal position</li>\n<li>the tip is above optimal position, but the trajectory of CVC is ok (give recommendation to push CVC a little deeper and it will be ok). This is why CVC in the shoulder is considered borderline - it is still on its way to the heart.</li>\n</ul>\n<p>Abnormal could be defined in 2 ways:</p>\n<ul>\n<li>the tip is way too deep in the heart</li>\n<li>there is no way for the tip to reach optimal CVC position - this happens when the CVC splits into wrong venae (i.e. goes into neck)</li>\n</ul>\n<p>for the last one, it can be illustrated as (red arrow my improvization)</p>\n<p><img src=\"https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F405318%2F02769f93533c7081597b7f0d7563f398%2FCentral-venous-catheter-1-abnormal-1.jpg?generation=1610203387916272&amp;alt=media\" alt=\"\"></p>\n<p><img src=\"https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F405318%2F8292ba916a9aefb366e692b107e3f49a%2FCentral-venous-catheter-1-abnormal-2.jpg?generation=1610203397621608&amp;alt=media\" alt=\"\"></p>\n<p><img src=\"https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F405318%2Ffcb1e5b5ce12451e1698cb5cc9c7c71f%2FCentral-venous-catheter-1-abnormal-3.jpg?generation=1610203406137598&amp;alt=media\" alt=\"\"></p>",
      "rawMarkdown": "Not a radiologist, but general rule of thumb - is the trajectory of CVC going a standard way - ideally CVC tip need to be placed in vena cava just before heart entrance.\n\nThe borderline in this competition is defined 2 ways:\n- the tip is just a little too deep optimal position\n- the tip is above optimal position, but the trajectory of CVC is ok (give recommendation to push CVC a little deeper and it will be ok). This is why CVC in the shoulder is considered borderline - it is still on its way to the heart.\n\nAbnormal could be defined in 2 ways:\n- the tip is way too deep in the heart\n- there is no way for the tip to reach optimal CVC position - this happens when the CVC splits into wrong venae (i.e. goes into neck)\n\nfor the last one, it can be illustrated as (red arrow my improvization)\n\n![](https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F405318%2F02769f93533c7081597b7f0d7563f398%2FCentral-venous-catheter-1-abnormal-1.jpg?generation=1610203387916272&alt=media)\n\n\n![](https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F405318%2F8292ba916a9aefb366e692b107e3f49a%2FCentral-venous-catheter-1-abnormal-2.jpg?generation=1610203397621608&alt=media)\n\n\n![](https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F405318%2Ffcb1e5b5ce12451e1698cb5cc9c7c71f%2FCentral-venous-catheter-1-abnormal-3.jpg?generation=1610203406137598&alt=media)",
      "votes": null
    },
    {
      "id": "1150700",
      "postDate": "01/12/2021 19:24:59",
      "content": "<h2>Central Line</h2>\n<p>The correct position of a central line is in the distal portion of the superior vena cava or at the junction of the superior vena cava and right atrium <img src=\"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/cms/asset/1f6c327d-7b43-42a8-b2da-c43319c62c62/anae14894-fig-0002-m.jpg\" alt=\"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/cms/asset/1f6c327d-7b43-42a8-b2da-c43319c62c62/anae14894-fig-0002-m.jpg\"><br>\n<a href=\"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.14894\" target=\"_blank\"> Image  from Central venous catheter tip position on chest radiographs</a></p>\n<h2>Midline</h2>\n<p>The line ending near the shoulder is not a central line, it is a midline, its tip should be in the axilla<img src=\"https://upload.wikimedia.org/wikipedia/commons/a/a6/Midline_Catheter.png\" alt=\"Midline\"></p>",
      "rawMarkdown": "## Central Line\nThe correct position of a central line is in the distal portion of the superior vena cava or at the junction of the superior vena cava and right atrium ![https://associationofanaesthetists-publications.onlinelibrary.wiley.com/cms/asset/1f6c327d-7b43-42a8-b2da-c43319c62c62/anae14894-fig-0002-m.jpg](https://associationofanaesthetists-publications.onlinelibrary.wiley.com/cms/asset/1f6c327d-7b43-42a8-b2da-c43319c62c62/anae14894-fig-0002-m.jpg)\n[ Image  from Central venous catheter tip position on chest radiographs](https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.14894)\n## Midline\nThe line ending near the shoulder is not a central line, it is a midline, its tip should be in the axilla![Midline](https://upload.wikimedia.org/wikipedia/commons/a/a6/Midline_Catheter.png)",
      "votes": null
    }
  ],
  "comments": [
    {
      "id": 1146100,
      "author_name": "raddar",
      "author_url": "",
      "post_date": "01/09/2021 14:43:36",
      "content": "<p>Not a radiologist, but general rule of thumb - is the trajectory of CVC going a standard way - ideally CVC tip need to be placed in vena cava just before heart entrance.</p>\n<p>The borderline in this competition is defined 2 ways:</p>\n<ul>\n<li>the tip is just a little too deep optimal position</li>\n<li>the tip is above optimal position, but the trajectory of CVC is ok (give recommendation to push CVC a little deeper and it will be ok). This is why CVC in the shoulder is considered borderline - it is still on its way to the heart.</li>\n</ul>\n<p>Abnormal could be defined in 2 ways:</p>\n<ul>\n<li>the tip is way too deep in the heart</li>\n<li>there is no way for the tip to reach optimal CVC position - this happens when the CVC splits into wrong venae (i.e. goes into neck)</li>\n</ul>\n<p>for the last one, it can be illustrated as (red arrow my improvization)</p>\n<p><img src=\"https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F405318%2F02769f93533c7081597b7f0d7563f398%2FCentral-venous-catheter-1-abnormal-1.jpg?generation=1610203387916272&amp;alt=media\" alt=\"\"></p>\n<p><img src=\"https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F405318%2F8292ba916a9aefb366e692b107e3f49a%2FCentral-venous-catheter-1-abnormal-2.jpg?generation=1610203397621608&amp;alt=media\" alt=\"\"></p>\n<p><img src=\"https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F405318%2Ffcb1e5b5ce12451e1698cb5cc9c7c71f%2FCentral-venous-catheter-1-abnormal-3.jpg?generation=1610203406137598&amp;alt=media\" alt=\"\"></p>",
      "votes": null,
      "replies": []
    },
    {
      "id": 1150700,
      "author_name": "agentili",
      "author_url": "",
      "post_date": "01/12/2021 19:24:59",
      "content": "<h2>Central Line</h2>\n<p>The correct position of a central line is in the distal portion of the superior vena cava or at the junction of the superior vena cava and right atrium <img src=\"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/cms/asset/1f6c327d-7b43-42a8-b2da-c43319c62c62/anae14894-fig-0002-m.jpg\" alt=\"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/cms/asset/1f6c327d-7b43-42a8-b2da-c43319c62c62/anae14894-fig-0002-m.jpg\"><br>\n<a href=\"https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.14894\" target=\"_blank\"> Image  from Central venous catheter tip position on chest radiographs</a></p>\n<h2>Midline</h2>\n<p>The line ending near the shoulder is not a central line, it is a midline, its tip should be in the axilla<img src=\"https://upload.wikimedia.org/wikipedia/commons/a/a6/Midline_Catheter.png\" alt=\"Midline\"></p>",
      "votes": null,
      "replies": []
    }
  ],
  "raw_markdown_by_id": {
    "1145526": "how can we decide if the cvc placement is good at the shoulder?\n\n![](https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F113660%2F37c8fa5cf85d6dea9bf2b385a56ad07a%2FSelection_131.png?generation=1610178975200419&alt=media)",
    "1146100": "Not a radiologist, but general rule of thumb - is the trajectory of CVC going a standard way - ideally CVC tip need to be placed in vena cava just before heart entrance.\n\nThe borderline in this competition is defined 2 ways:\n- the tip is just a little too deep optimal position\n- the tip is above optimal position, but the trajectory of CVC is ok (give recommendation to push CVC a little deeper and it will be ok). This is why CVC in the shoulder is considered borderline - it is still on its way to the heart.\n\nAbnormal could be defined in 2 ways:\n- the tip is way too deep in the heart\n- there is no way for the tip to reach optimal CVC position - this happens when the CVC splits into wrong venae (i.e. goes into neck)\n\nfor the last one, it can be illustrated as (red arrow my improvization)\n\n![](https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F405318%2F02769f93533c7081597b7f0d7563f398%2FCentral-venous-catheter-1-abnormal-1.jpg?generation=1610203387916272&alt=media)\n\n\n![](https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F405318%2F8292ba916a9aefb366e692b107e3f49a%2FCentral-venous-catheter-1-abnormal-2.jpg?generation=1610203397621608&alt=media)\n\n\n![](https://www.googleapis.com/download/storage/v1/b/kaggle-forum-message-attachments/o/inbox%2F405318%2Ffcb1e5b5ce12451e1698cb5cc9c7c71f%2FCentral-venous-catheter-1-abnormal-3.jpg?generation=1610203406137598&alt=media)",
    "1150700": "## Central Line\nThe correct position of a central line is in the distal portion of the superior vena cava or at the junction of the superior vena cava and right atrium ![https://associationofanaesthetists-publications.onlinelibrary.wiley.com/cms/asset/1f6c327d-7b43-42a8-b2da-c43319c62c62/anae14894-fig-0002-m.jpg](https://associationofanaesthetists-publications.onlinelibrary.wiley.com/cms/asset/1f6c327d-7b43-42a8-b2da-c43319c62c62/anae14894-fig-0002-m.jpg)\n[ Image  from Central venous catheter tip position on chest radiographs](https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.14894)\n## Midline\nThe line ending near the shoulder is not a central line, it is a midline, its tip should be in the axilla![Midline](https://upload.wikimedia.org/wikipedia/commons/a/a6/Midline_Catheter.png)"
  },
  "source": "meta"
}