The process of setting up a stable hemodynamic circuit to accurately measure blood pressure through arterial lines is essential in medicine and special care should be taken to ensure that the line is properly inserted into the person. Hemodynamic transducers should be zeroed at each initial set-up and a prepackaged “radial artery catheterization” kit is provided before the initial set-up of the arterial line triangulation system. Typical kits should include a local anesthesia solution, chlorhexidine or iodine solution for sterility of the wound, gauze pads, adhesive medical tape, a wrist splint, fine nylon sutures, and the needle that will be used to penetrate the radial artery. (Ramsey, 2018)
In order to insert the arterial line, the patient’s wrist should be extended and secured with tape to ensure there is no movement. Then, the artery should be lightly palpated to determine the location of the insertion site. The skin should be thoroughly cleaned with antiseptic solution and the needle attached to a catheter should be inserted at a steady rate at an angle of about 45 degrees directly into the radial artery. Remove the needle and keep the catheter placed in the patient’s artery. Smooth removal and no disruptions in blood flow or bruising should indicate a successful placement of the line. Special attention should be directed toward placing the arterial line in the patient correctly to avoid thrombosis, air in the blood, and significant bruising. The next step in the set-up process is rezeroing the actual transducer in order to expose the machine to atmospheric pressure and to ensure that there is no air in the arterial line. Any air in the arterial line is extremely dangerous to the patient and could enter the patient’s bloodstream, causing the blockage of blood flow in the capillaries or other small vessels in the body. The last step in our set up is the triangulation system to monitor the patient’s movement which is discussed in part two of our design set-up.
As a side note, the arterial line does not have to be used with the radial artery, however, it is the most common site of insertion. The location of the artery does not significantly interfere with the placement of the arterial line. All of the same steps above should be followed for the preferred artery. A different artery could be chosen due to, infection at the insertion site, blood clots (thrombosis) near the insertion site, and active Raynaud’s Syndrome. (Kouz, 2020)
References:
Kouz, K. (2020). How to measure blood pressure using an arterial catheter: a systemic 5-step approach. Retrieved from https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-02859-w#citeas
Ramsey, L. (2018). Arterial Line Placement: Basics for Medical Students. Retrieved from https://www.emra.org/emresident/article/arterial-line-placement/
Yartsev, A. (2015, 09/07/2021). The arterial line pressure transducer setup. Retrieved from https://derangedphysiology.com/main/cicm-primary-exam/required-reading/cardiovascular-system/Chapter%20758/arterial-line-pressure-transducer-setup