A- Lines
Arterial Pressure Monitoring
Jessica Rago
Description
• Arterial Pressure monitoring is a form of
invasive blood pressure monitoring and is
done through the cannulation of a
peripheral artery. This technique involves
direct measurement of arterial blood
pressure by inserting a cannula needle.
This will then be connected to a sterile,
fluid filled system, which is connected to
an electric patient monitor.
• Common sites include radial, brachial,
and femoral arteries.
• The radial site is the most common because it
allows for easy access, accurate readings, easy
bleeding control, circulation, and easy mobility
for the patient.
20XX
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Type of patient
This device is indicated for patients who
require continuous 24/7 monitoring of their
blood pressure. These patients include:
•
•
•
Those who are on continuous IV infusions of
medications that affect cardiac output/ blood
pressure
Critically Ill patients in the ICU who require
close monitoring of their hemodynamics
Patients who require frequent lab draws
•
Includes patients on prolonged mechanical
ventilation
•
Allows for monitoring of Hemoglobin and
hematocrit
Treatment of electrolyte imbalances
•
•
20XX
Patients undergoing surgery who are more
likely to suffer from or die from preexisting
comorbidities (i.e. cardiac, pulmonary,
anemia, etc.) or who are undergoing more
complicated procedure where large blood loss
is anticipated.
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An arterial line is a tiny catheter that is placed
into an artery. It is commonly used to monitor
blood pressure accurately as well as to monitor
blood pressure medications titration. It is also
beneficial when blood samples are required so
that the patient does not have to be poked
repeatedly. It is also convenient to get samples
for arterial blood gas analysis (ABGs).
What is the
role of this
technology
This is a beneficial system because it allows
the patients blood pressure to be continuously
monitored, where a waveform will be shown
Risk vs. Benefits
• Infection
• Lack of circulation
• Resulting in vascular
insufficiency
• Formation of a hematoma
• Formation of an AV fistula
• Stenosis of the vessel
• Blood loss (major bleeding)
• Embolism of air or thrombotic
material
• Vascular thrombosis and
occlusion
• Pseudoaneurysm formation
• Local nerve injury
20XX
• Help with early diagnosis
• High blood pressure
• Can rule out white coat
hypertension
• Can identify masked
hypertension
• Stroke, heart disease, and
organ damage are
reduced
• Ambulatory monitoring
• Useful for evaluating a
patient's response to longacting antihypertensive
medication
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NURSING ROLE
•
Assess the arterial waveform
•
•
•
Zeroing the a- line every 4 hours, at change of shift, after blood
draws, and at the time of any inaccuracy
Assess site for bleeding, dislodgement, hematoma formation, and
infection
•
•
5 P’s: pain, pallor, pulses, paresthesia, and paralysis
Dressing Change
•
•
Address inaccuracies that can be identified by comparing the a- line blood
pressure reading to a manual blood pressure reading
Every 7 days as needed using a chlorhexidine gluconate transparent
dressing, or every 24 hours if using gauze
Maintain Accuracy
•
If the line becomes dampened, blood backs up or becomes difficult to flush
•
•
•
20XX
Confirm there is at least 250 mL of saline in the flush bag
Confirm the bag is pressurized to at least 300 mHg
Confirm that the pressurized bag is on the IV pole
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Felician Values
RESPECT FOR HUMAN DIGNITY
COMPASSION
By displaying an understanding of the
needs
and situations of others we can
demonstrate a sympathetic
consciousness when caring for
20XX
patients.
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We respect everyone regardless
of color, religion, or financial
status. We do this to constantly
show our respect and dedication
to our patients and continue to
uphold their rights.
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Resources
http://www.memscap.com/applications-and-market-segments/medical-and-biomedical/invasiveblood-pressure
https://www.ncbi.nlm.nih.gov/books/NBK556127/
https://www.ncbi.nlm.nih.gov/books/NBK556127/
https://ccforum.biomedcentral.com/articles/10.1186/s13054-020-02859
w#:~:text=Major%2C%20but%20less%20common%2C%20complications,%25%20of%20cases%2
0%5B17%5D.
https://my.clevelandclinic.org/health/diagnostics/16330-24-hour-ambulatory-blood-pressuremonitoring
https://www.lhsc.on.ca/critical-care-trauma-centre/standard-of-care-arterial-line-monitoring
https://www.mometrix.com/academy/nursing-care-of-arteriallines/#:~:text=Also%20known%20as%20an%20art,titration%20of%20blood%20pressure%20medic
ations.