Arterial Cannulation INDICATIONS Continuous real-time blood pressure monitoring Blood pressure monitoring when noninvasive methods have failed Repeated sampling of arterial blood dentify the artery by palpation and anatomic landmarks Enter the artery with the bevel facing the oncoming blood: Technique Radial artery: 30-degree angle, 2-3 cm proximal to volar wrist crease Femoral artery: 45-degree angle, 3-4 cm distal to inguinal ligament Brachial artery: 30-degree angle, 1-2 cm proximal to the volar elbow crease Dorsalis pedis: 30-degree angle Catheter advancement (no guidewire): Slowly advance catheter assembly until blood fills the flash chamber. Reduce the angle of the catheter assembly to less than 30 degrees. Advance the entire assembly several millimeters. Carefully advance the catheter over the needle up to the hub. Catheter advancement using a guidewire: Slowly advance the catheter until blood fills the flash chamber. Gently advance until the needle pierces the back wall of the artery. Remove the needle, holding the catheter in place. Reduce the angle of the catheter to less than 30 degrees. Partly withdraw the catheter and insert the guidewire. Guide the catheter over the guidewire, then remove the guidewire. Catheter advancement using the Arrow arterial catheterization set: Check for passage of the wire through the needle then retract the wire. Enter the selected artery. Try not to pierce the back wall of the vessel. Gently advance the wire through needle. Advance the entire assembly 1-2 mm. Gently advance the catheter over the wire until the hub is at the skin. Hold the catheter in place, and then remove the needle and wire. Attach the tubing from the transducer system to the catheter. Secure the catheter to the skin with suture and with a catheter holder, tape, or needle securing device.

• published: 03 Sep 2013
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