Arterial Line Insertion

What is an Arterial Line insertion?

Arterial line insertion is a common procedure for management of critically ill Patients in various settings. Intra-arterial blood(blood in the arteries) pressure measurement is more accurate than blood pressure obtained by noninvasive means(i.e. with blood pressure cuff), especially in the critically ill Intensive Care Patient.Intra-arterial blood pressure management allows for the rapid recognition of changes in blood pressure vital for Patients on continuous infusions of vasoactive drugs. Arterial cannulation also allows for repeated arterial blood gas samples to be drawn without injury to the Patient.

Overall, arterial line insertion is considered a safe procedure with a rate of major complications less than 1%.Arterial lines can be placed in multiple arteries, with the most common insertion sites the radial(wrist), brachial(elbow) and femoral(groin). The most common site of cannulation is the radial artery(wrist), followed by the femoral artery(groin).The radial(wrist) artery is the site of choice by many due to its ease of cannulation, consistent anatomy, and low rate of complications.The femoral(groin) artery has the advantage of having a lower risk of thrombosis, but overall a similar rate of complications.

An arterial line is a fine plastic tube, called a cannula, which is inserted into the Patients’ artery. The cannula is attached to a transducer and infusion line (drip). Arterial lines can also be referred as Arterial Catheter,  ‘arterial cannulae’ or ‘art lines’.

  • What is it?
  • Why is it done?
  • What is done?
  • How is the arterial line removed?

What is it?

An arterial line, or art-line, or a-line, is a thin catheter inserted into an artery. It is most commonly used in intensive care medicine and anesthesia to monitor the blood pressure in real-time (rather than by intermittent measurement), and to obtain samples for arterial blood gas measurements. It is not generally used to administer medication. The cannula is attached to a transducer and infusion line (drip) with a pressure bag, to stop the blood from returning. The transducer transduces or transmits the blood pressure reading to the bedside monitor for display

What is done?

The doctor inserts the arterial cannula into an artery usually in the wrist, (radial) or in the patients’ groin, (femoral). The insertion site is cleaned with antiseptic to prevent infection. The doctor may inject a small amount of local anaesthetic which can “sting’ and this will numb the area when the doctor inserts the cannula into the artery.

Most Patients in Intensive Care require frequent blood tests and the arterial line provides easy access to draw blood samples. Therefore the number of times a blood vessel needs to be punctured with a needle is minimised and therefore optimises Patient comfort. Arterial blood gases (ABG) are important blood tests that assist in monitoring the Patient’s oxygen status. An ABG can only be taken from an artery.

The arterial line is secured, covered with a plastic dressing and can be held in position by an arm board and a bandage.


How is the arterial line removed?

A nurse removes the arterial line. The nurse takes the catheter out of the artery and will apply firm pressure, for about 3-5 minutes, to the incision site to stop and  prevent bleeding. A small dressing will be placed over the site.

Any Questions?

Of course, if you have any questions or concerns, please discuss them with the ICU nurses and doctors.

All Intensive Care interventions and procedures carry a degree of potential risk even when performed by skilled and experienced staff. Please discuss these issues with the medical and nursing staff who are caring for your loved one.

The information contained on this page is general in nature and therefore cannot reflect individual patient variation. It is meant as a back up to specific information which will be discussed with you by the Doctors and Nurses caring for your loved one. INTENSIVE CARE HOTLINE attests to the accuracy of the information contained here BUT takes no responsibility for how it may apply to an individual patient. Please refer to the full disclaimer.

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