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