Pressors and Arterial Lines

[HarleyNrs]

What are the standards for your unit? most places I have worked if you had pressors running you had an art line for continuous monitoring. Where I work now they run pressors with q5-10 minuted cuff bp's. It drives me nuts watching the continuous stimulation these critical babies are getting from this type of monitoring.

All input appreciated.

[BittyBabyGrower, MSN, RN]

We like to have an arterial line, but sometimes we can't get one on the kid, so we use cuff pressures. Sometimes you have to make due with what you have.

[mom to a PRINCESS]

Q10-15min cuff pressures?? Are you kidding me!! What about a kid w/PPHN? The less stimulation the better, I am sure they are sedated, and in that case I would definately want an a-line for continuous pressure monitoring, not to mention the fact that you are doing frequent blood gases AND the PO2 reading is critical! We do cuff pressures Q 2 hours to check correlation of the A-line reading. They can't get a UAC or peripheral arterial line in?

[dawngloves, BSN, RN]

Sometimes they can't get an A line in. If you're in a teaching hospital and your resident has blown every possible route leaving little for the fellow or attending, then cuff BPs are your only option. And yes, it is a PITA.

[wensday, MSN, RN, APN, NP]

We have art lines as much as possible. With regards to the using up routes, we have a 2strikes policy. If the more juniors don't get it after 2goes it moves up in seniority. Usually in the really sick ones they just start with the consultant/senior registrar doing the femoral (if UAC/radial has been tried previously).

[HarleyNrs]

Thanks everyone. I too, am used to having A lines with sick kids. This was new to me. This place will have a

[RainDreamer, BSN, RN]

I've never taken care of a kid on pressors with no A line. I guess it could happen though as sometimes it takes a while to get an A line in, but usually one of our neos can get it. But I agree that would stink with having to get continuous cuff pressures.

[SteveNNP, MSN, NP]

I've had to do serial pressures on a kid who kept clotting off his A-lines (can we say black fingers and toes all around? this is after clotting his UAC as well) It's a pain, but it's what you have to do sometimes. Definitely not routine practice here... I've maybe had to do it 2-3 times in 2 years...

[lovemyjob]

I think it is unacceptable to not even try....

Those poor heels