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30 Cards in this Set
- Front
- Back
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Need for continuous BP monitoring, induced hypotension, major end-organ disease, frequent blood sampling
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Indications for art line
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Non-invasive BP measurement failure, determination of volume responsiveness, long case duration
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Indications for art line
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H/o radial artery harvesting, advanced atherosclerotic disease, infection at cannulation site
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Contraindications for art line
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Vascular insufficiency at cannulation site - Raynaud's, thromboangitis obliterans, coagulopathy
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Contraindications for art line
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If a pt is septic and you place an a-line, they could lose a
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Thumb
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Distal ischemia, pseudoaneurysm, thromboembolism
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Vascular complications of a line placement
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Hemorrhage/hematoma, infection, neuropathy, misinterpretation of the data
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Complications of invasive BP monitoring
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Most commonly site used
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Radial
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Superficial, accessible, easy to cannulate, rare complications, good collateral flow
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Reasons why radial is the most commonly used site
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The brachial artery is easy to locate in the:
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Antecubital fossa
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The brachial site has rare ischemic complications despite lack of:
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Collateral flow
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The _____ site has a risk of ischemia b/c there is no collateral flow
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Femoral
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The femoral site has a higher risk of:
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Pseudoaneurysm
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______ is usually used when there has been difficulty in getting the aline.
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Transfixation
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With transfixation you go _____ the vessel, back out till you get blood flow, place the wire, then thread the cannula over the wire.
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Thru and thru
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_____ sites needs a longer catheter, and you only use the seldinger technique
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Brachial and femoral arteries
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Must be below inguinal ligament to avoid concealed hemorrhage into pelvis/peritoneum
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Site for femoral artery puncture
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The pressure transducer system is a:
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Underdamped, second-order dynamic system
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The pressure transducer system converts raw physical data into:
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Electrical energy
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Converts pressure (force/area) into an electrical signal
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Transducer
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Slow upstroke, absent dicrotic notch, narrow pulse pressure, mean~right
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Overdamped
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Systolic plus 2 times the diastolic all divided by three
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Mean
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You can use a rose filter with an
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Overdamped waveform
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Systolic overshoot, wave artifact, overestimates SBP by 25%, underestimates DBP by 10%
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Underdamped
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Increased HR, tubing too long, small internal tube diameter, catheter too large for vessel, excessive stopcocks
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Waveform distortion causing underdampening
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Kinked catheter, air bubbles, thrombi
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Waveform distortion causing overdamping
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If you are having trouble with your aline waveform or readings, always remember to:
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Visualize the site under the drape, etc
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Limit the ____ of the tubing
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Length
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____ maximum stopcocks
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2
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Purge all
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Air bubbles
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