Ultrasound for art lines

jer_sd · Sep 14, 2006

I have use a site right and sonosite for venous and arterial access. The sonosite is much better for imaging quality, site right easier to use.

underdog · Sep 14, 2006

Come on...who need U/S for a-line placement.

Feel the pulse....be the pulse.....stick the pulse!!!

SIMPLE!!!

PICC ACE · Sep 14, 2006

critical care medicine. 31(2):481-484, february 2003

levin, phillip d. mb, bchir; sheinin, olga md; gozal, yaacov md

abstract:

objective: to assess the role of a portable ultrasound device in the insertion of radial artery catheters.

design: prospective, randomized, comparative study.

setting: tertiary university hospital.

patients: elective surgery patients requiring arterial catheter insertion for intraoperative monitoring.

interventions: a portable ultrasound device was used to visualize the radial artery at the wrist and to direct arterial catheter insertion. this new technique of arterial catheter insertion was compared with the classic palpation technique.

measurements and main results: a total of 69 patients requiring an arterial catheter were randomized to either the ultrasound (34 patients) or palpation technique (35 patients). the time taken from skin puncture to successful arterial catheter insertion, the time taken per insertion attempt, the number of attempts required, and the number of cannulae used were recorded for each group. the arterial cannula was inserted on the first attempt in 21 (62%) cases using ultrasound vs. 12 (34%) cases by palpation (p = .03). significantly fewer attempts were required for catheter insertion using ultrasound as compared with palpation (mean +/- sd, 1.6 +/- 1.0 vs. 3.1 +/- 2.4;p = .003); however, the time taken for each successful attempt was longer (26.1 +/- 2.0 vs. 17.3 +/- 1.6 secs, p = .001). a trend toward shorter overall time required for catheter insertion was found for the ultrasound group (55.5 +/- 63.8 vs. 111.5 +/- 121.5 secs, p = .17). there were four failures in the ultrasound group and one in the palpation group (not significant).

conclusions: ultrasound is a useful adjunct to arterial catheter insertion and increases the rate of success at first attempt. the technique is easy to learn and may reduce the time taken to insert the catheter.

published by lippincott williams & wilkins.

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Brenna's Dad · Sep 20, 2006

In training we were frequently called up to the ICU to place A lines in edematous impossible pts. Excellent experience!!

Although we sometimes tried the Doppler to locate the pulse, I never really felt this was helpful. US probably would have been. I thought I was somewhat proficient with the Sonosite when finding veins in the ICU before anesthesia school.

But part of me must agree with underdog. Using "the force" often seems to be the best method.