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Anesthesia - ART LINE PROCEDURE - Coggle Diagram
Anesthesia - ART LINE PROCEDURE
CONFIRM PHYSICIAN ORDER
NOD
"Hi, my name is Rachel I'm with Respiratory & I'm here to put a catheter in your wrist to help monitor your BP better"
"Do you have any questions about it?"
CONFIRM PT ID
ASSESS FOR CONTRAINDICATIONS OR COMPLICATIONS
1) Are you on any blood thinners?
2) Do you have any other medical conditions? Raynauds? Peripheral vascular disease?
3) Look for trauma, infection, burns, fistula at the wrist **
4) Assess pulse & circulation of limb - color of the limb?
ENSURE NOT POIKING SIDE W/ BP CUFF ON IT
PERFORM MODIFIED ALLENS TEST
"Alright so I'm just going to check the circulation in your hand"
-Palpate for radial & ulnar A
"I'll get you to make a nice tight fist & then I'm just gonna give you a squeeze on your wrist here"
-Occlude radial & ulnar A
"I'll get you to open your hand"
-Check that its blanched & then release the ulnar A while still holding radial to see if theres collateral circulation
Positive Mod. Allens test = reperfusion within 6 seconds = OKAY TO POKE SITE
Alright, I'm just going to gather some equipment & I'll be back in a few minutes. Any questions at all?
Gather Equipment
1) Minor Suture bundle
2) Sterile Gown
3) Sterile Gloves
4) Soluprep
5) Small towel
6) Alcohol swabs
7) 1% Lidocaine
8) 20 Ga Needle
9) 18 Ga Needle
10) 22 Ga needle
11) 3cc Syringe
12) Sutures
13) Clear tape
Prepare pressure infuser bag & pressure transducer line
1) Pump the pressure bag up until you see the green zone & then make that color show by half
2) Prime the line by having sampling syringe stopcock vertical & stopcock above transducer off to atmosphere, & roller clamp off
3) Pull on the pig tail (blue dingly bit on the pressure transducer) & fluid should come out of the line to flush & prime it
4) Now its ready to connect to pt cath
1 more item...
(-) Mod Allens Test = no reperfusion within 6 seconds = TRY OTHER ARM
If other arm is the same, contact MRHP to use alternate site
-Brachial, femoral, axillary, dorsalis pedis