Arterial Line Placement by J. DiNardo | OPENPediatrics
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- Опубликовано: 7 сен 2024
- Learn about placing arterial pressure monitoring catheters, including indications, contraindications, equipment, and procedural techniques.
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Hi, my name is Jim DiNardo. I am an associate professor of anesthesia at Harvard Medical School and I’m one of the cardiac anesthesiologists and cardiac ICU attendings here at Children's Hospital Boston. We are going to be talking about arterial pressure monitoring today, specifically placement of arterial pressure monitoring catheters.
Indications:
The indications for placing an arterial line include patients who require continuous blood pressure monitoring, such as those who: are hemodynamically unstable, require vasoactive agents or active volume resuscitation, or in whom non-invasive blood pressure monitoring is unreliable or unobtainable. Patients who require significant respiratory support and need frequent lab sampling, including regular arterial blood gases. But these indications must be weighed against the potential risks: infection, trauma to the artery, potential thrombosis, hematoma.
Contraindications:
Some healthcare providers would refrain from performing this procedure in patients with: infection at the insertion site, traumatic injury proximal to the insertion site, inadequate collateral circulation of the extremity indicated by a failed Allen’s test.
Complications:
The complications that you may observe include: infection, trauma to the artery, thrombosis.
Equipment:
You will need the following equipment to perform the procedure: arm board, tape, chlorhexadine prep solution, arterial catheter, guidewire (we must make sure that the guidewire fits through the catheter), T-connector, sterile occlusive dressing, sterile gloves, sterile towels, transducer system, saline flush.
Good point about causing an intimate flap and the guide wire not being able to pass.
The best teaching video of A-line placement so far in my experience as a CRNA. I wish I had instructors/professors like Dr. DiNardo!!! For those who have Dr. DiNardo, you’re so lucky!
The best teaching video.Thanks
Excellent
Wonderful demonstration. Thank u
Outstanding teaching video
Great video from beginning to end
Good content and good explanation
Great video
thanks for nice video.
Excellent teaching video
Best video 💯💯
In the 'through and through' technique - why wouldn't the guidewire simply go out through hole you created in the posterior wall of the artery instead of going along the lumen of the artery?
IT IS SIMPLY ADEQUATE AND ABSOULTELY HELPFULL,PLEASE MAKE A VIDEO ON PRIMING IT WITH TRANSDUCER AS WELL...THANK YOU...
the content was very good.
What about infiltration of the site with local anesthetic before the actual arterial access.
It's was lovely.. thanks 😊
Amazing ❤
Would be great to show video of placing at other sites, especially posterior tibial artery
Excellent
So nice vedio great and easy to understand thank you so much
Great video, thanks!
Very well done. Perfect length.
Perfect. Very helpful. Thank you.
This video contains enough inforation...so thanks for this video..
V helpfull 👍
Thank you sir for providing information
Excellent vıdeo thanx a lot
Helpful
This was just excellent for me, it was quite comprehensive. Thanks a lot.
Fabulous realy such a graet guidance for this
Very well done!
Very well done video, thank you team, OPEN Paediatrics
Great video, thank you
A very informative video! I learned a lot.
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Great work Keep on
Great video! As a nurse who used to work in the ICU, it is nice to see such a clear explanation. I provide nurses with educational videos on my channel and think I might look at ART lines, from a nursing perspective :)
nice explanation
Very easy content and understandabale
Excellent explanation! Now I know what to expect next week.
Great video!
Very compact and comprehensive. Thanks
thanks
great video
Very good
Great video to show the main elements of this procedure. I would love to see how hemodynamically unstable blood pressure is taken. Thanks. Mohammed Qutyan, Nursing Student.
Very good content...
Great video.thanks a ton..!!
Very simple & good demo
good video
Very , very good: was too simples e Not too long! Thank you!
Thank you for your feedback. For more videos like this, please visit www.openpediatrics.org.
we never used guide wire
nursing student... thank you
Matthew B
Hi, don't you guys routinely use USG for arterial line placement ?
Dr. Abhishek Tandon MD
Nice vedio
i was bothered by the lack of chlorhexedine dressing placed at the end 😂
He also was not wearing a mask, even Pre-Covid it was required, Also did not discuss how to suture the catheter as the #1 Rule after any a-line is placed is "DO NOT LET IT BE PULLED OUT", So should he have used HCG-impregnated "gel dress" or "sponge dress"? Is that a universal recommend for pediatric art line placement, based on extensive research?
C'mon, this was just an educational video on a-line placement technique, not a presentation on CLABSI prevention.
Maybe he is not a very good Cardiac/Pediatric Anesthesiologist or educator? On the Contrary, as this little video made for OPENPediatrics featured James DiNardo, an actual Master of Anesthesia far beyond a-line placement. He was my "Obi-Wan" when I was a resident in early '90s, and he is still rocking it.
FWIW, In 2011 the CDC agreed with use of HCG-infused dressing for peripheral arterial lines, then in 2017 removed that rec if placed in under 18yo patients. Since then, various organizations and professional societies greatly vary on this, especially for Peds patients, the younger the more risk of significant dermatitis developing in few days.
Curious, where did you do your Anes Residency? Or perhaps Pedi ICU advanced nurse certification?
Its vein no
Its not an artery bcz artery blood will splash. He punchered vein
I had this done years ago in 2020, due to having COVID-19 viruses 3 times and the last one was the worst of the worst. Consider a law hauler due to the COVID.🦼🦽🚔🐾🧑🚒👮🧕🧑🦽🧑🦯🧑🦼🧑🦼💅✍️
Great video.
Great video