Brachial arterial line insertion // brachial arterial line placement
Radial arterial cannulation is a core skill in anesthesiology, intensive care, emergency medicine, and other acute care specialities. This video summarizes key principles for success with the anatomical landmark-guided (LMG) technique while minimizing complications.
These include:
(1) developing a tactile sense for locating the artery by palpation
Indications:-Indications for arterial line placement are as follows: Continuous direct BP monitoring - Arterial catheter MAP measurements are even more accurate than sphygmomanometric BP readings in patients who are morbidly obese, are very thin, have severe extremity burns, or are hypotensive, Frequent arterial blood gas specimens, Frequent blood sampling for diagnostic testing, need for frequent blood draws, sever diabetic ketoacidosis, sever hyponatremia, sever hypernatremia etc.
(2) accurate alignment during cannula advancement
(3) adopting an appropriately shallow trajectory to avoid transfixion (which increases risk of complications such as hematoma, thrombosis, arteriovenous fistula, catheter related blood stream infection etc)
(4) confirming intra-luminal cannula placement before attempting to thread it in.
1- Long vs short cannula
2- Position and taping
3- Line of sight insertion
4- Draping the hand
5- Palpation of artery
6- Insertion point
7- "Poke" vs "Puncture" point
8- Insertion trajectory
9- Advancing the cannula
9- Confirming intraluminal cannula tip placement
10- Connection of line tubing
11- Securing the cannula in place
12- Redirection to locate artery
13- Superficial radial artery
09:35 - Calcified radial artery
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Central Venous Catheter (CVC)/ Central line insertion-Internal Jugular Vein #central line insertion #central line placement #medical