zeroing pressure lines

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:nurse:Recently I had a patient with a radial art line and a PA line. I zeroed the PA to the phlebostatic axis and the art line at the point of insertion. I was reprimanded as it seems that hospital's policy is to zero ALL lines to the phleb. axis. I believe that's wrong because the art line in that position can't "see" all the way up the arm to the axis. There was quite a discussion. What do you guys :idea:think?

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I was always taught to zero everything to the phleb axis. Though I don't know much about your argument that it cant "see" all the way up to the axis. Usually our patients have CVPs, A-lines and they are all on the same manifold (I think thats what they are called) so it would be a pain to try to zero the a-line to the point of insertion and the CVP, Swan, ect to the phleb. axis.

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Specializes in ICU/Burn ICU/MSICU/NeuroICU.
:nurse:Recently I had a patient with a radial art line and a PA line. I zeroed the PA to the phlebostatic axis and the art line at the point of insertion. I was reprimanded as it seems that hospital's policy is to zero ALL lines to the phleb. axis. I believe that's wrong because the art line in that position can't "see" all the way up the arm to the axis. There was quite a discussion. What do you guys :idea:think?

It is not wrong if that is their policy. You were wrong!

Mind expanding on the "can't-See" thing about the Artline?

We all know Art lines placed further away from the heart will not be accurate, will tend to be dampened compared to what the Aorta is "seeing" and all that. And you also know they'll read differently from right to left placement...So whats your beef with zeroing at the axis?

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Specializes in MICU/SICU.

All of ours get zeroed to phleb axis.

I don't understand your comment about "seeing" either....could you expand on it?

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We all know Art lines placed further away from the heart will not be accurate, will tend to be dampened compared to what the Aorta is "seeing" and all that. And you also know they'll read differently from right to left placement...So whats your beef with zeroing at the axis?

I assume this is what they meant about the "seeing" part of it. Though I am interested if there was something more to it. Also the other part about the hospitals protocol/policy is what should be followed as if you don't follow their policy and something happens you are MORE responsible than the hospital and the blame can be placed on you.

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Specializes in ICU/Burn ICU/MSICU/NeuroICU.

Though I am not the OP here ( Original Poster), I am glad some are following this.

I think this old thread from AllNurses.com is divine!

https://allnurses.com/ccu-nursing-forum/arterial-line-question-130180-page2.html

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Hi, I'm the op. Sorry I took so long to reply but I had some trouble remembering my login. My problem was that the art line can only sense the pressure at point of insertion so measurements from zeroing at the phleb. axis are inaccurate. Vasoactive drips are titrated to these numbers. I heard in a class given by the author of the book on central lines(sorry , forgot name) that zeroing should be at insertion point. Do you giys zero @ the phleb axis when the art line is the only line? To protect myself , stram 87 brings up a good point. I just wanted to be as accurate as possible to give the patient appropriate treatment.:nurse:

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Specializes in ICU.

I learned many many moons ago that lines (A-line, CVP, PA) are zero'd at the phlebostatic arch.....however, the hospital policy where I work at now states A-lines are zero'd at the insertion site, so that's what I do

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