Arterial Line Insertion
Indications
Invasive blood pressure monitoring, frequent arterial blood gas testing
Contraindications
Coagulopathy, inadequate collateral circulation
Equipment & Preparation
How To Perform
Explain the procedure and ask for patient's consent
Position the patient
Prepare Sterile Field
Scrub, don sterile gloves and gown
Prepare Sterile Equipment
Draw up local, place everything in the order it will be used
Prepare the Site
Decontaminate a wide area e.g. with chlorhexidine + alcohol
Apply the fenestrated drape
Palpate the Pulse
Radial, brachial or femoral
Inject Local Anaesthetic
Adjacent to the pulsation + 2cm distal to insertion site
Insert Needle
Using dominant hand, non-dominant hand on pulse
Pencil grip, bevel up, 45 degrees from skin until pulsating flashback
If the needle or catheter must be removed at any time, place pressure on the insertion site for at least three minutes in order to prevent haematoma formation.
Advance the Guide Wire
Through the needle, soft & flexible end first
Remove the Needle
While holding onto guidewire, apply pressure to site using gauze
Insert the Cannula
Railroad over the guidewire, always with one hand holding the guidewire
Remove the Guidewire
Ensure flashback from the cannula, then stop the flow using a bung
Suture the Cannula
On either site, approximately 2cm from the insertion site
Clean the Area
Normal saline, then with dry gauze
Apply Dressing
Sterile, transparent occlusive dressing
Remove the drape
Connect the cannula to the transducer system and flush the line
Clean Up
Dispose of sharps and other waste