Arterial line caps

[RNMOM27]

Whenever I set up an arterial line I was told I have to change the caps on the tubing prior to hooking up the art line to my patient. Well a veteran Er nurse told me you don’t have to and can zero out the line with the vented caps. OK, I believed the nurse since they know more than me- I’m new at this. Well my charge nurse was not happy about it and said you can’t zero out the line unless you change out the caps. I’ve been searching non-stop for the correct answer. Does anyone know ? At the end of the day I just want to make sure I’m doing what’s right for my patients. 

[MunoRN, RN]

The transducer can be zeroed with the vented cap that the set comes with, and depending how you use your transducers that cap should not be replaced with one of the "dead-ender" caps that comes with the set.

The vented cap that comes on the transducer allows for repeated zeroing of the transducer while also preventing contamination of the port.  If the vented cap is replaced with a dead-end cap then the cap must be removed with each zeroing, and typically the same (now potentially contaminated) cap is put back on the port.

The exception would be if your practice is to tape the transducer to the patient or to keep the transducer in the bed with the patient, in which case the vented cap may not be enough to protect the port from contamination that wouldn't occur if placed on an IV pole or other device.  I would argue that isn't typically good practice though, with the exception of transport for instance, where it might make the most sense to tape it to the phlebostatic axis while packaged up in a helicopter.

[JBMmom, MSN, NP]

We also always change the vented caps to the dead end caps in order to reduce the possibility of contamination in the system. I believe that you can zero the line with the vented caps, but it's not that hard to remove the red cap, zero the line and replace the cap with a new one. We do keep our transducers on poles, and the system is zeroed at the beginning of every shift and after any lines draws.