Femoral arterial line protocol

[dougnj01]

Recently we have had a lot of patients with femoral arterial lines after surgery. Currently in my unit the residents are required to remove these lines. The problem with waiting for the residents is that these patients may have femoral arterial lines for many days that are not needed. I am working on setting up a protocol for ICU nurses to remove femoral arterial lines and was wondering if any of you have protocols in your ICUs that allow nurses to remove femoral arterial lines.

[beckster_01, BSN, RN]

No protocols, we pull all our art lines unless they have platelets

[MYSTICOOKIEBEAR]

Whenever I pull an A-line, I go straight up cath lab rules on it. Minimum 20 minutes of solid pressure usually 30 minutes, CBR and completely flat for 4 hours post pull. I sometimes cheat with reverse Trendelenburg.

Too many times have I seen inadequate pressure held and inadequate supine bed rests from fem A line pulls that led to complications necessitating RBC tranfusions and some as bad as vascular surgery interventions. Few things ruin a patient's day more than a hematoma that affects hemodynamics and hgb levels and retroperitoneal bleed from an inadequately managed femoral arterial line pull.