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Arterial Cannula

Arterial Cannula

  • Wednesday, 15 May 2024
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Arterial Cannula

Arterial cannula is a commonly performed procedure in critical care and some anesthesia settings.arterial cannula It allows for invasive monitoring of blood pressure and access to arterial blood samples (for blood gas measurements, pH, glucose, etc). It is typically done with a radial or brachial artery peripherally or the femoral artery centrally. Regardless of the site, arterial lines require an appropriately skilled practitioner. It is a relatively safe procedure with major complications occurring in fewer than one percent of all arterial line placements.

A patient is prepared for arterial line insertion by having the site cleaned with an antiseptic and possibly numbing the area with an anesthetic agent.arterial cannula The physician or nurse then positions the patient in a comfortable position so that access to the blood vessel is feasible. The physician or nurse then cleans the intended insertion site and if necessary covers it with an occlusive dressing.

Once the site is prepared, palpation of the radial artery should be accomplished to ensure that it can be located and that it has a strong pulse. The radial artery is located over the ventrolateral distal wrist just medial to the flexor carpi radialis tendon and lateral to the fenestra latissiformis muscle. The physician or nurse should gently press the skin of the hand and wrist, moving slowly across the site to allow for careful and consistent palpation. The artery should be easily felt with the tip of the index finger of the nondominant hand, with a strong arterial pulse readily detected.

Once access to the artery is achieved, the Seldinger technique is used to insert a guidewire into the artery. This is followed by a needle placed over the guidewire to enter the lumen of the artery, and finally a catheter fed over the needle into the artery and into its lumen.

There are many potential complications of arterial cannulation. The most common is the inadvertent injection of drugs into the artery, which can cause digital ischaemia and lead to complications such as hypoxemia or pulmonary edema. Another potentially serious complication is the creation of gas emboli, which may cause neurological damage, particularly in the head or neck.

It is important to understand that arterial lines can also be contaminated by bacteria from the hands of the person performing the procedure, so it is important to ensure proper hand hygiene and cleaning during the process. This includes ensuring that gloves are changed frequently, washing the fingers with soap and water, and using alcohol wipes on the fingertips prior to each use.

Other complications of arterial cannulation include a falsely positive or negative arterial blood pressure due to the insertion site being too high or low, an undiagnosed infection at the insertion site, and slow limb growth in children if the site is on the lower extremity. It is also important to monitor the arterial line for signs of vascular compromise such as extreme paleness, coldness or a difference in O2 saturation between the limb with and without the arterial cannula.

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