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Discussion

arterial lines 101

Hello,

I encountered a patient with an arterial line while shadowing a nurse on ICU during clinical. Observed as she took a blood draw from the line and saw how careful she was in maneuvering the stopcocks. Why does a pt need an arterial line? And how long can it stay in w/o risk of infection? Was curious on the topic, but didn't want to bombard the nurse with all my questions during her shift :)

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    • Featured Replies

    Next time, ASK THE QUESTIONS! Your entire purpose for being there was to learn!

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    • Experts

    Arterial lines are for wo 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.... an a-line is necessary.

    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.

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    • Author

    Thanks for the info, was just curious about the uses for arterial lines and situations that would require a pt to have one. So now i know they are mostly used for shock, monitoring effects of inotropic drugs, and for monitoring ABGs.

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    While there is the risk of infection with any invasive catheter, an a-line is less likely to get infected than a central line. Generally the patient no longer needs the a-line or it stops working before you are worried about it being in for too long. I'd say most a-lines in my unit stay in for 2-5 days.

    Some of my biggest fears in nursing are forgetting to remove a tourniquet and leaving a stopcock turned the wrong way!

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