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  • Arterial Line Care: Critical Care Nursing Ii Dr. Samah Anwar

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    Mohamed Elkady
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    This document discusses arterial line care and monitoring. It describes how arterial lines are used to monitor blood pressure beat-to-beat and assess hemodynamic stability. Common insertion sites include the radial, brachial, and femoral arteries. Complications include infection, thrombosis, embolism, and bleeding. Nurses are responsible for ensuring accurate data by properly zeroing and leveling the system, assessing the arterial waveform, and integrating patient assessments into decision making.

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    This document discusses arterial line care and monitoring. It describes how arterial lines are used to monitor blood pressure beat-to-beat and assess hemodynamic stability. Common insertion sites include the radial, brachial, and femoral arteries. Complications include infection, thrombosis, embolism, and bleeding. Nurses are responsible for ensuring accurate data by properly zeroing and leveling the system, assessing the arterial waveform, and integrating patient assessments into decision making.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    23 views15 pages

    Arterial Line Care: Critical Care Nursing Ii Dr. Samah Anwar

    Uploaded by

    Mohamed Elkady
    This document discusses arterial line care and monitoring. It describes how arterial lines are used to monitor blood pressure beat-to-beat and assess hemodynamic stability. Common insertion sites include the radial, brachial, and femoral arteries. Complications include infection, thrombosis, embolism, and bleeding. Nurses are responsible for ensuring accurate data by properly zeroing and leveling the system, assessing the arterial waveform, and integrating patient assessments into decision making.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 15

    Arterial Line Care

    CRITICAL CARE NURSING II


    DR. SAMAH ANWAR
    Arterial pressure monitoring

     Gives the most accurate BP, Beat to beat analysis of BP


     Hemodynamic instability
     Frequent ABGs
     Efficacy of Vasoactive medications
    Arterial line Insertion

     Common Sites of insertion:


     Radial artery (most common)
     Brachial artery
     Femoral artery
     Important factors must be considered:
     Size of the artery
     Accessibility of the site
     Blood flow to the distal limb
    Arterial line monitoring system
    Equipment
    monitor

    300 mm Hg =
    3-5 ml/hr
    Arterial line
    Allens test

     
    https://www.youtube.com/watch?v=gdgomN6TsuE 
    Complications

     Infection

     Thrombosis

     Embolism-Air/clot

     Accidental blood loss (bleeding)

     Impaired circulation to extremity


    Nursing implications:

     Document assessment of extremity every 2 hrs for perfusion- colour,


    temperature, sensation, pulse, and capillary refill.

     Keep the patient’s wrist in a neutral position and place it on an arm


    board.

     When catheter is removed, ensure adequate pressure is applied to the site


    of insertion until hemostaisis is obtained.
    Nursing responsibilities

     To Ensure accurate Data


     Levelling the air fluid interface to phlebostatic axis ( zeroing
    stopcock)
     At 4th intercostal space and midpoint of the anterior-posterior chest diameter
     Patient Position
     Zeroing the transducer
     Close to patient, open to air
     Assessing dynamic responsiveness ( Square wave test)
    Correct wave form analysis with other variables.
    ( No hemodynamic parameter should be interpreted in isolation-
    integration of patient assessment are crucial to decision making.)
    Square-Wave Test
    Square-Wave Test

    Over damped system:


     Blood clots, blood left in catheter after sampling, air bubbles
     Flushor aspirate the system, disconnect from patient if needed to
    adequately flush / remove clots.
     Compliant tubing
     Change to non compliant tubing
     Loose connections
     Ensure all connections are secure.
     Kinks in the tubing
     Straighten the tubing
    Square-Wave Test

    Under damped System


     Excessive tubing Length(>36-48 inches)
     Remove extra tubing, stopcock, extensions
     Small bore tubing
     Cause unknown.
     Add a damping device
    .to reduce the effect
    Nursing responsibilities

     Document insertion site.


     Change the dressing according to the institutional policy
     Assess for signs of infection
     Date the dressing changes
     Maintain the patency of the flush system
     Flush the system after each use of the port
     Clear any blood from the tubing, port and stopcock
     Maintain the pressure at 300mm of Hg on the flush solution bag
     Ensure adequate amount of flush solution in the intravenous bag
    Cont….

     Ensure tightened connections in the tubing and flush system Keep tubing
    free of kink.

     Minimize excess tubing, number of stopcocks

     Place sterile cap on stopcocks.

     Ensure that alarm limits are kept and alarm are turn on.

     Limit disconnecting or opening the system.

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