Art Line Flashcards
What is arterial catheterisation?
Invasive procedure where a small catheter is inserted into patient’s artery
What does an art line provide?
- Beat-by-beat blood pressure reading
- Access for arterial blood gas samples
What do you need for an art line set-up?
- 500ml/1L saline
- Pressure bag
- Pressuring monitoring set
- Appropriate cable for monitor
- Stickers
What is the Allen’s test for?
Evaluate the adequacy of blood flow to the hand, specifically the radial and ulnar arteries.
To what level do you want to pump the pressure bag?
300mmHg
Which arteries can be used in arterial cannulation?
- Radial
- Femoral
- Brachial
- Dorsalis pedis
- Axillary
At what angle should the art line needle pierce the skin?
30-45°
Fundamental arterial pressure frequency – 1 beat = ?
1 beat = 1 wave
What is the dicrotic notch?
Aortic valve closure
What is arterial line damping?
A reduction or flattening of the arterial pressure waveform
What are causes of overdamping?
- Three-way taps
- Bubbles
- Clots
- Vasospasm
- Narrow, long or compliant tubing
- Kinks in the cannula or tubing
What is vasospasm?
Constriction or narrowing of a blood vessel, typically an artery, due to the spasm (or tightening) of the vessel’s smooth muscle.
What are the risks associated with an arterial line?
- Pain
- Bleeding
- Thrombosis
- Infection
- Ischaemia
- Air embolus
- Inadvertent drug administration
What is ischaemia?
Reduced or restricted blood flow to a part of the body, leading to a shortage of oxygen and nutrients that are necessary for tissue function.
What happens due to inadvertent drug administration in arterial line?
Ischaemia and gangrene
What are the signs of inadvertent drug administration?
- Severe pain
- Numbness/tingling
- Oedema
- Cyanosis
How do you manage inadvertent drug administration?
- Elevate affected limb
- Keep arterial catheter in place, begin slow infusion of NaCl
- Asses severity
- Consider anticoagulation treatment
- Treat pain and symptoms
- Re-asses regularly
- Document and incident report
Why should we elevate limb in inadvertent drug administration?
Improve venous and lymphatic drainage
What anticoagulation treatment should be considered in inadvertent drug administration?
IV heparin
Why keep the arterial line in place and infuse NaCl in inadvertent drug administration?
Maintain cannula patency
