Arterial catheterization

Essential equipment

Antiseptic solution1% lidocaine (without epinephrine)Arm board for brachial, radial, or ulnar cannulationAppropriately sized intravenous cathetersPressure tubing2 three-way stopcocksPressure transducer

Steps

  1. Ensure that equipment is ready, including a prepared pressure transducer line

  2. Immobilize hand and wrist in mild dorsiflexion

  3. Anesthetize skin

  4. Clean and prepare site using full sterile technique

  5. Locate radial pulse

  6. Advance needle into the artery distal to palpated pulse at a 30-45 degree angle to the skin. Confirm arterial puncture by observing a flash into the needle hub

  7. Drop angle of insertion and advance 2 mm confirming proper placement by observing continuous arterial blood return

  8. Feed catheter over needle or feed guidewire then catheter (depending on equipment)

  9. Apply external pressure over the artery proximal to the tip of the catheter and remove needle (and guidewire, if used)

  10. Attach catheter to pressure transducer line

  11. Suture catheter hub to the skin and dress appropriately