Arterial Lines

4006 Words Feb 27th, 2015 17 Pages
Arterial Lines 3/8/05

1- What is an a-line? 2- What are the parts of an a-line? 3- Does it matter if the flush setup is made with saline or heparin? 4- What are a-lines used for? 5- What do I have to think about before the a-line goes in? 6- What is an Allen test? 7- Where can a-lines go besides the radial artery? 8- Who inserts a-lines? 9- How is it done? 10- What kinds of problems can happen during a-line placement? 11- How do I use an a-line to monitor blood pressure? 12- How should I set the alarm limits? 13- How do I draw blood samples from a-lines? 14- What order
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4- What are a-lines used for?

Two things mainly: blood pressure monitoring, and for patients who need frequent blood draws. Any patient on more than a small amount of any vasoactive drip really needs to have an a-line for proper BP management – if they’re sick enough to be put in the unit and need pressors, then they’re sick enough for an a-line. Non-invasive automatic blood pressure cuffs are useful, but if a person is labile – push for an a-line.

Certain situations absolutely require an a-line for BP monitoring: any use of any dose of nipride, for example. This is a truly powerful drug – it works very quickly, and your patient can rapidly get into all sorts of trouble unless you’re monitoring BP continuously.

I’ve heard lately that there’s a trend towards using fewer a-lines – it seems silly (and painful) to have your patient get stuck what seems like twelve times in a shift for labs and ABGs. Remember that it’s always been our unit’s policy for nurses to send ABGs after every vent change, or for any clinical change that the patient makes.

Update – this has changed a little: ABGs probably don’t seem to be necessary for vent changes that are only going to affect oxygenation: changes in FiO2 or PEEP, since the O2 sat will keep you
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