Today, we talk about arterial lines. I love arterial lines: monitoring, true MAPs, easy blood draw, easy blood gases, fluid status–what's not to love.
This turned into a 2-parter. Part 1 covers radial art lines
Here is Arterial Lines – Part 2
covers everything else below
The (Essentials of EM)Crit Conference
go to EMCritConference.com
use the promo code “emcrit” when you sign up
Part 1 Covers:
Radial Arterial Lines
Peripheral vs. Central Arterial Lines
Here is a systematic review of most of the literature[cite]24413576[/cite]
My take on it is, use sterile gloves, mask, chlorhexidine prep, and if you can grab a fenestrated drape or some OR towels.
- Kit (The one I use is Arrow RA-04020)
- How to Save it
- Allen Test
Tegaderm alone is not enough. I suture, but I really wish we had arterial line stat-locks
I always loop around the thumb and secure with tape outside of the tegaderm–I hate replacing pulled out art lines
Central vs. Peripheral Arterial Pressures[cite]28523028[/cite]
Part 2 Covers:
unless you are going for speed or the Dirty Double
Find the Common Femoral Artery
Use of a central line kit?–No!
Back of wire? Check, but yes!
The Arterial Line Set-Up
How to set up an art line pressure transducer
Pimping Ammunition – Where is that Catheter
sent by Intensivist, Mark Dunn