JavaScript is disabled. Clinical review: complications and risk factors of peripheral arterial catheters used for haemodynamic monitoring in anaesthesia and intensive care medicine. The cannulation of deep arteries is frequently achieved using the modified Seldinger technique. Accreditation Information: KLA Education Services LLC is accredited by the These same attributes make the femoral artery the preferred choice for vascular access for surgical and interventional procedures. The needlewire device is then removed and the catheter is attached to the tubing and transducer. Square Wave Tests that Require Adjustments, The most frequent complication of invasive BP monitoring, 3 patient conditions that require continuous blood pressure monitoring, Necessary equipment for setting up an arterial line, 3 steps to ensure accuracy of waveform evaluation, Recommended patient position for zeroing of a transducer, Identify 5 distinct components of an arterial waveform, Steps for performing a dynamic response test (square wave test), 3 characteristics of an optimally damped system (normal square wave test), 3 characteristics of an overdamped system, 3 characteristics of an underdamped system. Evaluate the patient regularly for signs or symptoms of catheter-related infection, which can include (but are not limited to) fever, chills, tachycardia, increased white blood cell count, redness or swelling at catheter insertion site. Fortunately, there are a few things that can be done to fix an underdamped arterial line. If it is not securely fastened, it can move around and cause the blood flow to be inconsistent. The zero point is the point at which the line registers no pressure. This can lead to falsely low or high readings. The Arterial Line Assessment & Troubleshooting! - YouTube Transducer height (levelling) needs to be at level of right atrium (phlebostatic axis). Be sure to eliminate all air bubbles as they can be a main factor in waveform distortion. What causes a dampened arterial waveform in a catheter? If the catheter is unable to be placed due to obstruction or inability to advance the guidewire, the operator may notice diminution of a palpable pulse. These are skills we should all be able to do when it comes to helping manage the critically ill.
This is easily estimated by visual inspection, limits technical challenge, and is approximate to the level of the patients heart.1 This plane allows for accurate measurement of hydrostatic pressure within the heart. In addition to site selection, the incidence of thrombosis increases with duration of indwelling catheter use, length and gauge of arterial catheter selected, and predisposing hypercoagulable state.9 It is mitigated by use of a continuous flush system, which works to limit stagnation or turbulence of blood flow through the catheter. What is Overdamping and Underdamping in arterial line? on vasopressors) or. It is frequently associated with peripheral cannulation at radial and brachial sites, although has the potential to occur with any catheter. -Make sure the patient is not moving around too much. When do leveling and zeroing of the transducer need to be done?