• Intracavitary ECG is well supported in the adult and pediatric literature.

  • Most pediatric institutions have been slow to adopt IC-ECG.

  • With IC-ECG the use of a chest radiograph for PICC placement is unnecessary.


Proper peripherally inserted central catheter (PICC) placement has traditionally been confirmed by the use of a chest radiograph. With the innovation of the intracavitary electrocardiogram (IC-ECG), the use of a routine chest radiograph is not indicated. However, in many pediatric centers a chest radiograph is still required by policy. This article describes 4 cases in which PICC lines were properly placed using IC-ECG and the routine chest radiograph was unable to locate the PICC tip position.

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