Arterial Lines

Arterial lines are commonly used in ICUs to continuously monitor a patient's blood pressure.  Patients in my ICU that commonly have arterial lines are those who have gone to the OR, have poor arterial vasculature, have unreliable blood pressure readings, or have multiple vasopressor medications infusing.  Prior to the doctor inserting the arterial line, there is some prep work for you, as the nurse, to do. The video below talks about the different supplies needed to set up a transducer as well as how to prime the tubing. Be sure to inflate your pressure bag!  There was a time when I couldn't get the waveform of my arterial line to show up on the monitor...it would've helped if my pressure bag would've been inflated!

Setting up for an arterial line transducer.

Make sure to have the pressure tubing and transducer ready to go prior to the doctor inserting the arterial line.  Sometimes the art line will go in quickly and smoothly, and other times it is a difficult task to insert. The process of how the doctors actually insert the central line can be found below:

In addition to continuous blood pressure monitoring, arterial lines are also quite useful in telling acid-base balance and oxygenation levels. The video below shows how to draw off of an arterial line.  There are different types of pressure tubing that different hospitals use.  My hospital does not have the small needleless port for blood sampling (as shown in the video).  Instead, there is a luer lock port.  I attach my syringe to the luer lock, turn the stop cock (on the port) off to the transducer side, and draw my wasted blood sample from the patient. After this, you turn the stop cock back to the neutral position (so that blood doesn't squirt out at you when you take your syringe off), remove the wasted blood syringe, and connect your next syringe (for actual sampling). Turn the stopcock back off to the transducer side and draw your samples. After you have drawn your sample, turn the stop cock back to the neutral position and flush the line using the flush mechanism on the transducer. Do not ever risk introducing air into your arterial line by flushing the line with a syringe, and do not ever infuse medications through an arterial line.

Arterial line insertion.

How to collect an arterial line blood sample.