# Ultrasound-guided Radial Arterial Line Placement

- Link: https://sifsof.com/clinical-apps/radial-arterial-line-placement/
- Published: 2020-02-28T02:48:18+00:00
- Author: Developer

Insertion of a radial arterial catheter is a common procedure in critical care 
units. Radial artery catheters are commonly placed for continuous blood pressure
monitoring, frequent arterial blood gas analysis, or frequent blood sampling for
diagnostic testing.

Radial artery cannulation can be challenging and ultrasound guidance has emerged
as a valuable adjunct for the placement of radial artery catheters. The advantages
of ultrasound guidance include: real-time visualization of landmarks, improved pre-
procedure planning, reduction in complications, less time spent at the bedside, 
and improved first-attempt success rates.

## **Which ultrasound scanner is best for radial arterial line placement**?

 The radial artery is identified using a linear or vascular probe [SIFULTRAS-3.31](https://sifsof.com/product/color-doppler-3-in-1-wireless-ultrasound-scanner-sifultras-3-31/).
The probe is placed on the wrist where the pulse is palpated (or via anatomic landmarks
if there is no palpable pulse) or along the forearm and wrist. 

  The traditional method for radial artery catheter placement is to locate the vessel
via palpation of the pulse or anatomic landmarks. Unfortunately, anatomic landmarks
may not locate the radial artery in up to 30% of patients.

 In patients with severe hypotension, morbid obesity, and atherosclerosis, the radial
pulse may be weak or absent, making locating the artery via palpation difficult.

 Other difficulties commonly encountered during radial artery catheter placement
include: the inability to thread the wire, hematoma formation, scarring from previous
arterial catheters, atherosclerosis, and arterial spasm.

Different methods can be adopted for radial arterial mine placement. The first is
the transverse method, where the probe is placed perpendicular to the artery. The
second technique is the longitudinal method, where the probe is oriented parallel
to the vessel. A third method is the static technique, where the vessel is identified
via ultrasound, and a mark is made on the skin along the artery’s path with a sterile
marker.

 Ultrasound guidance has been shown to reduce complications and increase success
rates for bedside clinicians, including respiratory therapists (RTs), during central
venous catheter insertion.

 Ultrasound guidance reduced the mean number of attempts required for successful
catheter placement, reduced time to successful catheter placement, and reduced the
number of hematomas.

 Ultrasound guidance reduces the likelihood of hitting the nerve bundle and other
structures near the artery due to real-time visualization of the needle as it approaches
the artery and underlying structures.  Ultrasound should minimize this difficulty
and reduce the risk of vessel damage and morbidity because real-time guidance reduces
the likelihood of hitting underlying structures, such as nerves, ligaments, and 
tendons.

Arterial lines are typically inserted by [Physicians](https://sifsof.com/product-category/doctor-specialties/family-medicine-physician/),
Acute Care Nurse Practitioners (ACNP), ICU Physician Assistants (PAs), [Anesthesiologist](https://sifsof.com/product-category/doctor-specialties/anesthesiologist/)
Assistants (CAAs), Nurse Anesthetists (CRNAs), and Respiratory Therapists.

  References: [Review of Ultrasound-Guided Radial Artery Catheter Placement](https://rc.rcjournal.com/content/61/3/383),
[Ultrasound-Guided Insertion of a Radial Arterial Catheter](https://www.nejm.org/doi/full/10.1056/NEJMvcm1213181).

![](https://sifsof.com/wp-content/uploads/2020/02/ultrasound-guided-radial-arterial-
line-placement.jpeg)

 * ![Color Doppler 3 in 1 Wireless Ultrasound Scanner SIFULTRAS-3.31 main](https://
   sifsof.com/wp-content/uploads/2019/10/SIFULTRAS-3.31-main-picture-300x300.jpg)
 * Color Doppler 3 in 1 Wireless Ultrasound Scanner SIFULTRAS-3.31
 * ![3 in 1 Color Doppler Wireless Ultrasound Scanner SIFULTRAS-3.32 main pic](https://
   sifsof.com/wp-content/uploads/2020/02/3in1-Wireless-multipurpose-color-doppler-
   ultrasound-scanner-probe-SIFULTRAS-3.32-300x300.jpg)
 * 3 in 1 Color Doppler Wireless Ultrasound Scanner SIFULTRAS-3.32
 * ![Wireless 3 in 1 Ultrasound Scanner SIFULTRAS-3.3 Triple Headed: Convex, Linear
   and Cardiac Probe main pic](https://sifsof.com/wp-content/uploads/2019/09/SIFULTRAS-
   3.3-main-picture-1-300x300.jpg)
 * 3 in 1 Ultrasound Scanner SIFULTRAS-3.3 Triple Headed: Convex, Linear and Cardiac

_Disclaimer: Although the information we provide is used by different doctors and
medical staff to perform their procedures and clinical applications, the information
contained in this article is for consideration only. SIFSOF is not responsible neither
for the misuse of the device nor for the wrong __or random__generalizability of 
the device in all clinical applications or procedures mentioned in our articles.
Users must have the proper training and skills to perform the procedure with each
vein finder device._

_The products mentioned in this article are only for sale to medical staff (doctors,
nurses, certified practitioners, etc.) or to private users assisted by or under 
the supervision of a medical professional.  _