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Discussion

Transduce or not transduce?

My unit is a Level III NICU that does not routinely transduce UAC's. Sometimes the UAC is placed ecause a UVC or PIV can't be inserted. The physician and the NNP's don't want to transduce those lines because of the cost of the transducer. If the infant isn't critically ill and isn't extremely preterm, they don't see a need to monitor invasive BP. I am trying to find evidenced-based practice guidelines stating that all arterial lines should be transduced if that is indeed the case. I know that an infant's condition can change at any time and that the transducer could detect changes. Any help appreciated that I could take to my supervisors for rationale to transduce these lines.

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I don't have any evidence/articles, but I think one huge benefit of always transducing is that monitoring pressure with the appropriate alarms would not only alert you to physiologic low blood pressure but also to other issues. I would like to know sooner than later if my line has been dislodged or there are other issues, and this is one way of monitoring that. However, we are different in that the only thing we EVER infuse into a UAC is UAC fluids, so the purpose of our lines is BP monitoring and lab draws.

I agree. Your pt may have a stable BP, but I'd like to know if there was an issue with my line. ( clotting off, dislodgement, air in line) They'd be real sorry if a kid bled out or lost a foot because they didn't want to spend money on a tranducer.

I also agree with the previous posters. Sometimes the first sign that the line is going bad is that the waveform stops "behaving".

I'd agree with PPs too, when your waveform goes flat then it makes you inspect every mm of that line. We always transduce every UAC, but then we only use them for BP and bloods.

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