ARTERIAL LINES

Arterial lines have a lot of utility in the ICU. They are never an “emergency” line (unless you truly cannot get a blood pressure) but add a lot of value to the work-up and monitoring of a patient. Some benefits include -

  1. You get a live, (for the most part) accurate blood pressure that changes by the second every time the blood hits the probe

    1. This includes in patient who has a cardiac arrest - you can visually see if there is a pulse back

  2. You are able to draw labs and ABGs from them - great for patients who are difficult arterial sticks

  3. You can connect it to flotrack and know more about the heart and volume status

Where can I put it?

We primarily place them in the radial and femoral arteries. Under VERY rare + special circumstances they can be placed in the ulnar, brachial or axillary arteries. Never place an a-line in the carotid artery.

A femoral arterial line kit

A femoral arterial line kit

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SO I WANNA DO A RADIAL ARTERY ARTERIAL LINE. WHAT DO I GET FROM THE CART?

  1. Stat lock - in a red package

  2. Probe cover - to be able to use your ultrasound sterile

  3. Biopatch - smallest size; to keep line clean afterward

  4. Tape - to tape down patients arm

  5. Sterile Towels - to create your sterile field (the drape in the a-line kit can also be used but its very small)

  6. Sterile gown - to get sterile

  7. Chloraprep - to clean the patients skin

  8. A-line kit - to do the actual a-line. For radial, only one size

  9. Non-sterile flushes - must squirt into kit, cannot drop them onto kit

  10. Sterile gloves in your size (not pictured)

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INSIDE AN ARTERIAL LINE KIT

  1. Drape - to keep area sterile if you don’t use sterile towels (see above)

  2. The wire - to do the seldinger technique

  3. Suture - if you’d like to suture it in (not recommended)

  4. Lidocaine - usually numbing the area is just as bad as the line but can be used if desired

  5. Gauze - a-lines are bloody; to keep it clean

  6. Long catheter - your actual “line” that stays in the patient

  7. Angiocath - can be used as alternative “line”

  8. Needle holder - to keep your sharps secure

  9. Blood port - to squirt blood into when doing the line

  10. Needle - to access the vessel

  11. Blade - shouldn’t be used