Arterial Line

Pre-procedure considerations

  • Palpate of artery of interest to best understand anatomy and surrounding structures
  • Allen Test if placing radial artery access: goal to assess collateral ulnar blood flow to avoid ischemia. Hold both radial and ulnar artery 10-15 sec to allow blanching of palm, then release ulnar artery to assess perfusion. If blanching quickly resolve, ulnar artery will allow distal perfusion
  • If attempting radial access, ensure wrist is adequately extended, often using towel roll under wrist and taping hand to bed or table

 

Procedure considerations

  • Types of Kits
    • Arrow kit: all-in-one device that has arterial catheter over introducer needle
    • A-line kit: individual introducer needle, guidewires, and sutures; multiple steps
    • Micropuncture kit: atraumatic guidewire, microcatheter and introducer sheath
  • Reconfirm location with US after lidocaine
  • Ensure arterial access (pulsatile flow of bright red blood)

 

Post- procedure considerations

  • Immediately connect pressure tubing to catheter while maintaining sterile technique
  • If persistent bleeding, hold pressure for 15 mins.
  • Can use for frequent ABG checks