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Systematic evaluation of ultrasound-guided radial arterial catheterization

"The arterial insertion method systematic evaluation may be utilized to reduce variation in practice and promote the use of ultrasound as a standard for the insertion of radial arterial catheters" Bardin-Spencer and Spencer (2020).

Abstract:

Introduction: Peripheral arterial catheter insertion is a common procedure for critically ill patients requiring frequent blood gas sampling and continuous blood pressure monitoring. There are clear advantages of ultrasound-guided arterial cannulation, which have shown to be more effective in reducing complications, time to successful cannulation, number of attempts, and overall first-time success rates. Evidence suggests that using palpation alone has a first-time success rate of less than 70% yet is still a widely performed technique. A systematic evaluation may be required to reduce variations in arterial catheterization practices.

Design: The arterial insertion method is a systematic evaluation to aid in arterial catheter insertion with ultrasound guidance, intended to improve the procedural approach. The process of arterial insertion method ensures appropriate choice of zone selection to optimize catheter longevity and performance in patients requiring arterial access. Moving the insertion site proximally 4 cm from the red zone into the green zone may reduce mechanical complications and preserve catheter performance and dwell time.

Conclusion: The standardization of ultrasound guidance in arterial catheterization promotes vessel health and patient safety through device and site optimization. The arterial insertion method systematic evaluation may be utilized to reduce variation in practice and promote the use of ultrasound as a standard for the insertion of radial arterial catheters.

Reference:

Bardin-Spencer AJ, Spencer TR. Arterial insertion method: A new method for systematic evaluation of ultrasound-guided radial arterial catheterization. J Vasc Access. 2020 Sep 28:1129729820944104. doi: 10.1177/1129729820944104. Epub ahead of print. PMID: 32985342.