Arterial Lines are invasive lines used to monitor blood pressure, heart rate, and oxygenation, and obtain blood samples for critically ill patients. This page describes Arterial Line Services, Placement, Use, Benefits, Risks, as well as Arterial Lines Care and Maintenance. Vascular Wellness is one of a very few Vascular Access nursing companies providing Arterial Lines Placement Services, and we believe the only one in the Southeastern United States, furthering our position as the most advanced and innovative vascular access company delivering clinical services to the bedside.
Arterial Line Services
Arterial Line Services by Vascular Wellness are provided by Vascular Access Board Certified (VA-BC) nurse clinicians. Using Ultrasound Guidance in delivering Arterial Line Services, Vascular Wellness improves patient outcomes and decreases risks associated with insertions or placements. This technology has a much higher success rate than just “feeling” for an artery and will prevent or mitigate most complications associated with insertions. In addition to Ultrasound guidance, Vascular Wellness clinicians utilize sterile techniques and anti-microbial dressings on Arterial Line Services, further reducing risks of infection and other problems.
Arterial Line Placement
Ultrasound-Guided Arterial Line Placement
Arterial Line Placement
Arterial Line Placement success is best achieved by expert clinicians using Ultrasound Guidance, as noted above, primarily because Arterial visualization is of the utmost importance. Arterial visualization helps the clinician achieve the primary goal of placing the catheter on the first attempt while avoiding additional morbidities such as hematoma, nerve injury, or impeding arterial flow to the extremity. In general, and after confirming sufficient collateral circulation, the Arterial Line Placement is first attempted in the radial artery (below thumb on underside of wrist). This allows the greatest margin of safety as the ulnar artery (underside of wrist on pinky side) provides collateral arterial flow to support proper circulation. Additionally, the location of the radial artery makes it easier to dress, care for, and maintain the line. If the radial artery is undersized, then the ulnar artery may be considered for first-time attempt of Arterial Line Placement.
Arterial Line Use
Arterial Line Use primarily consists of blood pressure monitoring and blood draws. With respect to use for blood pressure monitoring, Arterial Lines are ordered and placed as they are one of the most accurate ways to measure blood pressure. They can measure the pressure inside the artery giving accurate and real-time values of Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Mean Arterial Pressure (MAP). In addition, Arterial Line Use provides visual tracing of the line waveform showing, in part, systolic upstroke, peak systolic pressure, systolic decline, diastolic runoff, and minimum diastolic pressure. With an Arterial Line inserted, multiple and frequent blood draws can occur without additional sticks providing an easy way to take blood samples when needed.
Arterial Line Use for Blood Pressure Monitoring
Arterial Line Benefits
Arterial Line Benefits are very apparent and compelling since Arterial Lines provide immediate, catheter-to-monitor information on critically ill patients. Unlike the non-invasive blood pressure cuff, which can be less precise delaying decisions, Arterial Line Benefits include real-time information allowing for prompt and accurate titration of lifesaving medications. The improved accuracy is partially due to how the MAP is calculated. The MAP calculation does not depend on the placement proximity of the line or catheter to the heart, nor is it affected by the elasticity of the vessel. Arterial Line Benefits also include improved patient monitoring by incorporating alarms that alert staff to fluctuations in blood pressure, heart rate, and oxygen levels. Although the blood pressure cuff is non-invasive, it may not be an option for all patients such as burn victims or those that suffered other traumas. Arterial catheters remove the need for constant inflation/deflation of the blood pressure cuff and multiple needle sticks for blood draws around damaged tissue. They provide a comfortable, reliable, and superior solution when clinically appropriate.
Arterial Line Risks
Arterial Line Risks include the following possible complications: Hematoma, Bleeding, Thrombosis, Embolization, and Infection. Hematoma most often occurs with unguided procedures with either needle puncture of non-target vessels or a through and through puncture of the intended artery. Bleeding can be minor around the insertion site or more severe if arterial damage has occurred with an unguided puncture. Thrombosis occurs due to blood clots around the artery, and this risk increases with the catheter’s duration, length, and size as the catheter takes up space in the artery. This risk decreases with ultrasound visualization as the correct size artery and needle can be predetermined based on vein measurement with ultrasound assessment. Catheter embolization can occur with “blind” insertions (i.e., no visualization technologies), as the needle can inadvertently damage the catheter with repeated insertion attempts. Infection is one of the Arterial Line Risks, like the risk with any invasive procedure, such as a central line. The risk decreases with a skillful clinician performing the placement or insertion. Arterial Line Risks are generally similar to those of central lines, and like central lines, can be mitigated with proper clinical policies and procedures in accordance with best practices.
Arterial Line Care and Maintenance
Arterial Line Care and Maintenance is essential, like central lines, and must be performed. Proper line care, maintenance, and dressing changes are performed in conformity with healthcare facilities’ policies and involve everything from inspecting the catheter to the insertion site and tubing. Arterial Line Care and Maintenance also involves examining the pressure transduction system, which includes monitoring the calibration for correct pressure, the tubing on the pressure bag system, the fluid levels, the monitor, and the alarms set on the monitor. Arterial Line Care and Maintenance is necessary for accurate, ongoing patient assessment. If the line is no longer clinically indicated, it should be removed.
Arterial Line Care and Maintenance
VASCULAR ACCESS EXPERTS
As Vascular Access Experts, Vascular Wellness nurse clinicians are Vascular Access Board Certified (VA-BC), insured, skill-verified, and salaried W2 employees. Vascular Wellness requires bi-annual skill verification, ensuring adherence to proprietary policies, procedures, competencies, and best practices. Vascular Wellness employs a Director of Research and Development who not only helps us stay up to date on best practices but helps us continue to innovate and improve upon Vascular Access Services. In addition to Arterial Lines, some of these nursing advancements include Small Bore Axillary, Jugular, and Femoral Lines, Large Bore Lines, Vas-Caths for Dialysis, and Tunneled Catheters, including PermCaths for dialysis inserted at the bedside for appropriate patients.
Vascular Access Experts practice holistic medical care, meaning talking to the patient, addressing questions and fears, and performing a comprehensive medical review. Prior to delivering any Vascular Access procedure, the Vascular Wellness clinician reviews the patient’s medical record, including history and lab reports, and independently verifies and confirms the doctor’s order. If our clinician has questions or disagrees with the prescribing doctor, the clinician will consult with the doctor. Our Vascular Access Experts have earned the trust of many doctors, and such doctors will defer to the clinician’s recommendation by ordering a “consult” as compared to a specific line. Patient safety and vein preservation are critical – which is why a holistic, comprehensive evaluation and Advanced Lines are significant. Other companies claiming to be Vascular Access Experts may not follow this same approach, frustrating medical doctors, and nurses.
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Vascular Wellnesssm provides comprehensive, quality, timely, and innovative vascular access services, including standard and advanced line placement, pediatrics, program management, education, training, and infection control and prevention to all healthcare settings such as Tertiary Hospitals, Community Hospitals, Long-Term Acute Care Hospitals, Skilled Nursing Facilities, Surgical and Outpatient Centers, Hospice, and At-Home care. We support a 98+% Success Rate with zero (0) Insertion-Related Infections across all lines, with an average response time of 3 hours. We help our clients improve patient outcomes, enable faster therapy, reduce costs, infections, and readmissions, decrease hospital length of stay, and reduce transportation expenses.
Clinical Hours for Dispatch
Service Hours extend 2+ hours after Dispatch
Monday-Friday: 8am - 6pm
Saturday-Sunday: 8am - 3pm
Holidays: 8am - 1pm