Art Lines

Thats pretty strange. I wonder why they would do that?

Zeroing an art-line is an integral part of obtaining proper readings. I wonder if they have some new type of a-line/equipment? Some other reason??? If you find out,it'd be interesting to know why...

I usually zero my alines when I first come on shift or if I am doing any majoy HOB changes or getting up to a chair, etc. I also print and post a strip of the arterial line tracing once a shift. I think the policy states to rezero once a shift and/or after any major position changes. Our policy also states that a dynamic response test be done each shift.

I always level and zero my art lines with my initial assessment and compare to cuff pressure.

We zero at beginning of shift and compare to cuff pressure, if you've disconnected the transducer from the monitor (like after going on a road trip) and anytime you think you might have an inaccurate reading as a way of trouble shooting.

Same as most everyone above...

We are supposed to zero them once a shift, but of course not everybody does. We also re-zero them if there is a major change in position of if it's disconnected. We have new HP monitors. I also get a cuff BP with that first zero and assessment, just to be sure, especially if the patient is on pressors. Many of my coworkers only get cuff BPs if there is a dampened wave form with the art line, if there is noted hypotension, or if the line stops drawing back.

Of course, I work NICU not CCU, but an art line is an art line!

when I worked in ICU we zero once a shift and with position changes or if the system became open to air and we did cuff pressures q4hr. Now I work PACU. We zero on arrival and do cuff pressure on arrival and at discharge from pacu. The cuff pressures that I do ,I do mainly because the ICU will want to know. Most of the time they are in the opposite arm from the art line and do not corralate anyway due to pts carotid disease.

How close do the art lines and cuff pressures have to be for you to document art pressures as the "true" BP? A nurse I work with says within 20mmHG but that sounds like a huge margin of error.

This is pretty sad, but when it comes to comparing arterial pressure to NIBP, the surgeons I've worked with take the one they like the best (i.e., the non-hypo or hypertensive one). I usually don't like larger than a 10 - 15mmMg margin of error in comparing the two ... of course there are a million reasons for such anomalous readings (transducer not at phlebostatic axis, dampened wave form, patient's wrist bent every other minute, fibrin at tip of catheter, blah, blah, blah).

I think we have stumbled onto a world wide phenomenon here:D

Please think - why do we zero???

It is to correct for changes in atmospheric pressure. Since arterial pressures are usually monitored with a fluid system (unless you are using a fibreoptic system like Camino) then change in atmospheric pressure will affect the accuracy of the system. What we should be doing is watching the weather report - can you imagine it? Cyclone Harvey is coming - quick re-zero your art lines:roll It is easier just to do them routinely once a shift.

... Gee thanks Gwenith. I had no idea why we needed to zero the art line. I thought it was mainly for aesthetics...

How close do the art lines and cuff pressures have to be for you to document art pressures as the "true" BP? A nurse I work with says within 20mmHG but that sounds like a huge margin of error.

Our policy says within 20 points. you have to look at many different factors like Gwenyth mentioned-waveform, etc.... that can be a big margin, the main point is to be consistent, especially if titrating gtts to pressures.

Thanks for the answers everyone. I love this BB and the resources it gives us.