What do you guys use for art lines??

Pediatric Critical Care Columnist · Jul 5, 2011

Our unit is a similar size with about 65% cardiac patients. We use an open system too, and return the waste routinely. We're doing a number of research studies on our neonatal surgical patients (Norwoods and arterial switches mostly) that end up requiring MANY gases drawn... and at least one transfusion at some point down the road - even with the waste returned.

umcRN, BSN, RN · Jul 6, 2011

our PICU and Peds CICU use this system: http://www.cardinal.com/us/en/distributedproducts/ASP/PXVMP120.asp?cat=med_surg

We also use a closed system in the NICU but I cannot remember the name of it, it involves three seperatly packaged products though that we hook together, prime through and then connect to the a-line, once connected though its closed for sampling

kessadawn, BSN, RN · Jul 13, 2011

In my PICU we utilize a machine called a VIA (although I don't remember if that stands for anything). It is a blood analysis system that hooks into your arterial line setup and it allows for minimal blood drawn and minimal waste. It measures blood gas, H&H, sodium and potassium at the bedside. It's pretty cool, but sometimes a little tempermental when setting it up, before you attach to the patient, when it is running a self-calibration. It can be used on patients off all ages and sizes and has 2 settings, one for the neonate and one for older patients. We also use it in our NICU and our burns ICU.

Redneckmedic63 · Jul 20, 2011

In my PICU we utilize a machine called a VIA (although I don't remember if that stands for anything). It is a blood analysis system that hooks into your arterial line setup and it allows for minimal blood drawn and minimal waste. It measures blood gas, H&H, sodium and potassium at the bedside. It's pretty cool, but sometimes a little tempermental when setting it up, before you attach to the patient, when it is running a self-calibration. It can be used on patients off all ages and sizes and has 2 settings, one for the neonate and one for older patients. We also use it in our NICU and our burns ICU.

We do everything but open heart and ecmo here (12 bed PICU), but still have some pretty crappy neuro, trauma and oncology kids, as well as the usual respiratory. We routinely return waste. Still involves alot of blood loss for critical kids, so we try to keep labs to necessary minimum and bundle them so that we can draw multiple labs. We use open systems in PICU - the closed system the hospital uses is way too high a volume for what we prefer. Even using an open system, we are fortunate to have a VERY low line infection rate (went almost 3 years without one). But would love to have further info as well...

Can you PM me with a little more info on VIA - manufacturer? Getting ready to build all new PICU starting in a few months, and still tweeking designs and equipment! Couldn't find a lot when I googled - just curious!

Thanks - Joe :)

smmRN · Oct 20, 2011

I come from a 24 bed PICU & 12 bed CICU. Both units use the BD Closed Loop Blood Sampling Kits for all of our arterial lines. It allows us to safely draw labs without opening the line. I personally LOVE it because it is easy, quick, and you aren't breaking into the line multiple times to draw blood & flush. Plus you never waste blood, it all goes back to the patient without risk since it is a closed system. It only requires 2-3mls/hr of fluid to keep patent and you can control how much you flush with by attaching a syringe to the transducer instead of simply using the pull port.

NicuGal, MSN, RN · Oct 20, 2011

We use Biosensors. http://www.kentecmedical.com/manufacturer_detail.phtml?mfg_id=137&pline_id=143 I don't know why it has only a limited shipping area, we get them....maybe not updated lol But anywho, we really like these and we use them with our central line bundle. We will take the transducer off and use it on central lines of kids that need frequent blood draws too. We have never had a problem with them :) Our PICU uses these on occasion too.

ECMOismygame · Oct 29, 2011

We use Biosensors. http://www.kentecmedical.com/manufacturer_detail.phtml?mfg_id=137&pline_id=143 I don't know why it has only a limited shipping area, we get them....maybe not updated lol But anywho, we really like these and we use them with our central line bundle. We will take the transducer off and use it on central lines of kids that need frequent blood draws too. We have never had a problem with them :) Our PICU uses these on occasion too.

+1

The NICU, PICU, and pediatric CICU I previously worked in used this system. BSI rate dropped dramatically after implementation.

NewPICURN · Dec 10, 2011

I'm really not sure who makes our art line setup (we have a 26 bed PICU), but we use a closed system made up of a two 48 inch pressor tubing and a transducer with two syringe ports, one that we cap during setup and priming and never remove and the other that gets a 10 ml syringe attached during priming and is never removed except to zero. (let me know if I'm wrong in calling this a closed system. Because we use the 48 inch pressor tubing, we can draw the waste back into the tubing up to the transducer and clamp it, then draw the sample from the hub closest to the patient on the tubing, then flush and return all the waste blood.

kitdikat · Jan 17, 2012

Hello, a few people have provided feedback but I guess I will as well. We also have a lot of pediatric as well as neonatal hearts that we recover in our unit. For our pediatric patients' art lines, we use the closed system--the same we use for our CVPs. it's really nice--no waste because you can return everything to the patient, and it's set up with a pressure bag.

Our neonatal patients, however, are a different story. Our SCN and NICU use a different protocol than we do in the PICU. Their A-line and pressure lines are set up on an open system and placed on Alaris pumps that are continually infusing the heparin in NS solution. I ABSOLUTELY HATE THESE SET UPS! Unfortunately I have encountered them frequently in the past because our NICU surgeries are recovered in the PICU and then sent back to NICU--and while they are with us, they still keep all of their NICU protocols with the patient. The lines have given me a lot of trouble and I spent a whole 15 minutes trying to debug a CVP on a 3 week old preemie once--thankfully the line wasn't lost and the patient wasn't harmed. I suppose it's acceptable for the NICU nurses though, they are used to that system and they are allowed to return the waste to the patient without an order from their MDs. In the PICU we need an order to return the blood, but it's usually never an issue since all our peds patients are on the closed system.

MegNeoNurse · Feb 9, 2012

We use an inline system as well for art lines. Transpac® Disposable Pressure Transducers by ICU medical. We put a T connector at the hub of the catheter, pull waste back through closed system, clamp, access using needleless device at hub to draw specimen. Works out pretty nicely.

GatorRN21 · Mar 26, 2012

In our CICU, we use the VAMP system on all arterial lines, which is a closed system.

VAMP System

Unfortunately, the VAMP is only supposed to be placed on arterial lines, so all other lines we still use the open system (stop-cock). But our team rarely follows the mixed venous sat so we commonly aren't drawing/wasting blood from the other lines--mostly drawing from the art line.