Head and Neck Vein Access

Neonatal venous angulation between the external jugular and subclavian veins may cause flexible PICC tips to meet resistance. Forceful advancement when the catheter cannot advance may cause the tip to recoil or redirect toward the cervical vertebra. Head and neck vein insertion carried the highest concern for primary non-central PICC tip malposition. Most head and neck malposition cases had catheter tips folding beside the cervical vertebra. Head and neck PICCs were clinically associated with extravasation and unplanned removal in the department.