I read with interest "Perforation of the Great Vessels During Central Venous Line Placement," by Robinson et al.1 Their comment about central venous line placement currently being performed by physicians of all specialties, but most commonly by general and vascular surgeons, might be specific to their institution. This is in contradistinction to the practice at my institution, where the intensivists and anesthesiologists are the ones who place the central venous catheters, other than Hickman and Broviac catheters, which are placed by general surgeons. I believe that the way it is done at my institution is probably the norm nationally.
Also, Robinson and colleagues never state whether they use peripherally inserted central catheters. The use of these catheters has been described in the literature,2 as well as in a subsequent lively letter debate.3 Nurses can place this type of catheter.
I would be interested to know how Robinson