To decrease the chance that a peripherally inserted central catheter (PICC) will advance into the jugular vein, the inserter should

To decrease the chance that a peripherally inserted central catheter (PICC) will advance into the jugular vein, the inserter should

• A. Turn the head away from the insertion site
• B. Turn the head toward the insertion site
• C. Extend the neck
• D. Tilt the head to midline

Answer: (B)

Turning the head toward the insertion site helps align the venous pathway so the PICC tip advances into the lower superior vena cava rather than looping upward into the internal jugular vein. When the head is rotated to the side of the catheter, the angle at the central venous junction favors the catheter following the SVC path, reducing cephalad migration into the IJ. Extending the neck, tilting to midline, or turning the head away can alter these angles in a way that makes the catheter more likely to enter the jugular vein.

Turning the head toward the insertion site helps align the venous pathway so the PICC tip advances into the lower superior vena cava rather than looping upward into the internal jugular vein. When the head is rotated to the side of the catheter, the angle at the central venous junction favors the catheter following the SVC path, reducing cephalad migration into the IJ. Extending the neck, tilting to midline, or turning the head away can alter these angles in a way that makes the catheter more likely to enter the jugular vein.