II. Indications

  1. Serial Arterial Blood Gas monitoring
  2. Continuous Blood Pressure Monitoring

III. Technique: Preparation for Arterial Cannulation

  1. Perform Allen Test to confirm collateral circulation
  2. Heparinize syringe
    1. Start with 10 cc Syringe with stopcock
    2. Draw up 3-5 ml of Heparinized saline (50 units/ml)
  3. Obtain IV catheter
    1. Needle of 18 or 20 gauge with plastic cannula
    2. Flush with Heparinized saline
  4. Position patients wrist and hand
    1. Patient dorsiflexes wrist over towel pad
    2. Tape palm and upper Forearm to arm board
  5. Clean radial entry site
    1. Povidone-Iodine solution (betadine) scrub
    2. Alcohol scrub
  6. Local anesthetic at entry site
    1. Small skin wheal (1-2 ml) of Lidocaine 2%

IV. Technique: Placing Arterial Line

  1. Identify radial artery with gentle pressure
  2. Needle angled 45 degrees toward arm
  3. Enter skin just distal to palpated artery site
  4. Slowly advance needle until spontaneous blood enters
  5. Guide wire passed into artery
  6. Remove needle
  7. Advance flushed plastic cannula over top of guide wire
    1. Uses modified Seldinger technique
  8. Attach syringe of Heparinized saline
  9. Re-flush cannula with 2 cc Heparinized saline
  10. Turn Stopcock to seal artery
  11. Connect transducer and high-pressure infusion set
  12. Remove pad under wrist and secure arm board

V. Complications

  1. Arterial Thrombosis
    1. Risk increases with decreasing wrist circumference
    2. Risk increases rapidly in first 24 hours, than slowly
  2. Occult bleeding
  3. Cerebral embolization
    1. Occurs with vigorous Flushing of radial catheters
    2. Gentle irrigation with 1-2 ml boluses should be used
  4. Localized infection
    1. Risk increases after 72 hours
    2. Remove catheter at earliest possible time
    3. Provide careful wound and dressing care

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Ontology: Arterial Lines (C0003835)

Concepts Medical Device (T074)
MSH D062666 , D002408
SnomedCT 261241001
English arterial lines, arterial line, intra-arterial line, Lines, Arterial, Arterial Line, Line, Arterial, Intra-Arterial Line, Lines, Intra-Arterial, Intra-Arterial Lines, Intra Arterial Lines, Line, Intra-Arterial, Arterial line, Arterial line (physical object), Arterial Lines
Czech nitrotepenné kanyly
French Lignes artérielles
German Intraarterielle Katheter, Arterielle Verweilkatheter
Italian Linee endoarteriose, Linee arteriose
Spanish Líneas Intraarteriales, Líneas Arteriales, línea arterial (objeto físico), línea arterial
Portuguese Linhas Arteriais, Linhas Intra-Arteriais
Norwegian Arteriekatetre, Intraarteriekatetre
Dutch Lijnen, arteriële, Lijnen, intra-arteriële

Ontology: Arterial catheterization (C0007431)

Concepts Therapeutic or Preventive Procedure (T061)
ICD9 38.91
ICD10 694
SnomedCT 58983009, 81757005, 151029000, 91575007, 151023004, 392247006, 392248001
CPT 36625
English Arterial catheterization, Artery catheter insertion, Catheterization arterial NOS, Needling, arterial catheterization, arterial catheterization (treatment), Catheterisation arterial NOS, insertion arterial line, arterial cannulation, artery catheterization, needling, arterial catheter insertion, arterial catheterisation, arterial catheterizations, needl, Catheterization arterial, Cannulation of artery (procedure), Catheterisation arterial, Catheterization of artery, Cannulation of artery, Insertion of catheter into artery, Arterial cannula insertion, Arterial catheter insertion, Arterial line insertion, Intra-arterial cannulation, Arterial cannulation, Arterial catheterisation, Catheterisation of artery, Insertion of catheter into artery (procedure), Arterial cannula insertion (procedure)
Italian Cateterismo arterioso, Cateterismo arterioso non specificato
Dutch arteriële katheterisatie NAO, katheterisatie arterieel, arteriële katheterisatie
French Cathétérisme artériel, Cathétérisme artériel SAI, Cathétérisation artérielle
German Arterienkatheterisierung NNB, Katheterisierung arteriell, Arterienkatheterisierung
Portuguese Cateterismo arterial, Cateterismo arterial NE, Cateterização arterial
Spanish Cateterismo arterial NEOM, inserción de un catéter en una arteria, cateterismo de una arteria, inserción de un catéter en una arteria (procedimiento), canulación de una arteria, canulación de una arteria (procedimiento), cateterismo arterial, inserción de catéter en arteria (procedimiento), inserción de catéter en arteria, inserción de cánula arterial (procedimiento), inserción de cánula arterial, Cateterismo arterial
Japanese 動脈カテーテル, 動脈カテーテルNOS, ドウミャクカテーテルNOS, ドウミャクカテーテル
Czech Katetrizace arteriální NOS, Katetrizace arteriální, Arteriální katetrizace
Hungarian Katéterezés, arterialis, Artérialis katéterezés, Arteriális katéterezés, Artéria katéterezés k.m.n.