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What About A Radial Arterial Line?


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#21 BrianACNP

BrianACNP

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Posted 29 October 2012 - 04:48 PM

I'm a, I'm a, I'm a...ha ha. Ok, so at least you've got the skill and I absolutely applaud you for that. Tedious? Absolutely! I've had to start wearing glasses (like I'm suppose to) after squinting at the screen for long periods of time. I will say that what gives me best results more than anything is sitting on stool, getting comfortable, and taking my time. Plenty of jelly, no balcony full of question askers, color doppler, taking the time to perfect the gain, depth, and focus. Also, frequency of use. This is one skill that I will jump from others just to stay good at it. One tip which you probably already know, but I see others not appreciate is that prolonged exposure to the US beam in one spot will start to heat up tissue. I can't give you an exact number/time frame but it can start to burn after a long hold in one place. Anywho, I apologize if I was a bit of an ass in my remark, but good job on advancing your skill set. It kills me watching folks dig and dig for a gas over and over, COME ON? I wish more people would pick up this skill, it is totally a patient satisfaction issue. Just FYI, with frequent use it is possible to get good at peripherial IV's in the forearm. A trick that helps me is to start with an art dart in the vein so that the guide-wire can be used as well as the more flexible catheter has more success of passing that sharper angle of attack on the US guided IV. You can come behind that and exchange it depending on what kind of toys you have. You can get proficient at rad art lines with frequent use of the skill. If you already started Levo and Vaso, I just start working up the limb until I can see pulsatile flow. I am still waiting for the IV sets with built in guide wires to come on the market.


I actually do not have a need to use ultrasound. I only use it when I can barely feel a pulse wherever I'm looking. It's a little easier to do it by feel when typically you have a pulse to go by. It is without a doubt one of the harder skills to be proficient in since the usual targeted arteries are quite small. Ultrasound won't help you much with that.

Brian
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Brian, MSN, ACNP, CCRN

#22 medsrgw

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Posted 28 November 2013 - 01:08 PM

I actually do not have a need to use ultrasound. I only use it when I can barely feel a pulse wherever I'm looking. It's a little easier to do it by feel when typically you have a pulse to go by. It is without a doubt one of the harder skills to be proficient in since the usual targeted arteries are quite small. Ultrasound won't help you much with that.

Brian


Ultrasound WILL help with small arteries, and even veins, but there is a steep learning curve! Don't dismiss it even in the small babies :)
RW
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