Arterial Lines

Indications for an arterial line include frequent ABG's, pressor requirements, or any hemodynamic instability. 

Step 1: Choose your site. Options include radial, basilic, axillary, or femoral artery. While looking for this, have the RN set up a pressure bag.. 

Step 2: Consent patient and gather supplies. For radial lines, this includes mask, sterile gloves, ChloraPrep, US sleeve (if using US), radial arterial line catheter, 4x4 gauze, and sterile dressing. For non-sedated patients, 1% lidocaine with administration needle and syringe may be helpful. 

For non-radial lines, an arterial line kit may be used and will include most of the above items with the exception of the US sleeve. 

Step 3: Cleanse the site and in sterile fashion open all of your supplies. Using US, administer lidocaine (if using) to the area superficial to the artery you have chosen. 

Step 4: Access the artery using needle and syringe or Arrow Radial A-line catheter and needle. Once access has been achieved, place guidewire through the access needle. 

Step 5: Remove the needle, leaving the access wire in place. For radial A-lines, hold pressure over the access site. 

Step 6: Slide the arterial line catheter over the wire. This should enter the artery without resistance.  Once the catheter is all of the way in, remove the wire and attach the catheter immediately to a pressure bag. 

Step 7: Secure the radial a-line (Axillary and femoral lines should be sutured) with a dressing. The RN will zero the line and an arterial waveform should be present on the monitor.