Arterial Line Setup

arterial line blood pressure invasive device monitoring patient safety safety Apr 18, 2024
Setting up for an arterial line is a simple but important skill for anaesthetic nurses. If you’re starting out, ask your nurse buddies to show you their art line hacks. There are many different brands of transducer sets and each have their own little quirks! πŸ©ΈπŸ’‰
 
First, gather equipment:
 
1️⃣ 500ml NS
2️⃣ Pressure bag
3️⃣ Transducer set & labels
4️⃣ Transducer holder
5️⃣ Transducer cable
6️⃣ Cannulation equipment
πŸ‘‰ Cannula, swab, dressing, local anaesthetic, gloves
πŸ‘‰ Something to position the wrist (bolster and tape)
7️⃣ Ultrasound machine if difficult
 
Then, set it up by following the 4 Ps:
 
1️⃣ Prepare the set
πŸ‘‰ Hand hygiene
πŸ‘‰ Open transducer set
πŸ‘‰ Tighten connections
πŸ‘‰ Place saline bag inside pressure bag, hang it on an IV pole
πŸ‘‰ Attach the transducer holder and insert the transducer
 
2️⃣ Prime the line
πŸ‘‰ Pressurise saline bag to 300mmHg and close pressure bag switch to prevent deflation
πŸ‘‰ Spike the saline bag with the transducer set & allow line to prime completely
 
3️⃣ Purge connections
πŸ‘‰There are usually two “3-way” connections. These contain air and should be flushed
πŸ‘‰ To purge with saline, close the 3-way tap to the patient (which opens it to the pressure line) and activate the “flush valve” so saline flows through.
πŸ‘‰ Now you should be able to inspect the entire line and ensure there are no bubbles present.
 
4️⃣ Perform zero
πŸ‘‰ The pressure transducer relies on an accurate “atmospheric” pressure to use as a “zero”.
πŸ‘‰ Zeroing can be performed before or after connecting to the patient, however, it MUST be done prior to observing a blood pressure reading. To zero, turn the transducer switch so that it is “off to the patient and open to air” and press the “zero” button on the monitor.
πŸ‘‰ The transducer should be at the same height as the right atrium (the arm pit is a good reference). In a true “beach chair” position, it may be applied at the level of the ear to measure brain perfusion.
 
Remember to attach & complete labels according to your hospital guidelines and document appropriately. βœ…πŸ˜

Build knowledgeβœ…

Improve safetyβœ… 

Ref: https://coreem.net/procedures/how-to-set-up-an-arterial-line/



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