A-line hints

[kaos]

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I've been told by a medicine resident way back when that there was a quick and dirty way to get a good stick on the first try, but I can't remember the pointers. Anybody have any ideas?

 

[jennyboo]

Haha.... Different people have their different tricks, but there is no quick and dirty way that works instantly for everyone -- ability comes with experience. An IM resident is the last person to ask about quick and dirty a-line tricks. 😉

 

[lattimer13]

go to the anesthesiology forum...i know one of the guys over there has a thread titled something to the same effect.

 

[PickyBicky]

I've been told by a medicine resident way back when that there was a quick and dirty way to get a good stick on the first try, but I can't remember the pointers. Anybody have any ideas?

The New England Journal recently pubished an online video on A-line insertion that is about 10 minutes long and can be helpful. Go to NEJM.org at a site (such as your school) that has institutional access and search for arterial line insertion (or videos in clinical medicine).

-PB

 

[roja]

Best trick: Take a PPD/insulin syringe, draw up 1cc of lidocaine without epi- feel for a pulse and inject near it (pulling back first to check for blood). Give it a good 60 seconds to work and then feel for the pulse, hold the needle like a pencil and go. The lidocaine makes it a- more comfortable for the patient and b-allows you to manuever a little in case you 'miss'.

two finger vs one is a style thing. try them both and see which works best for you.


Best hint for any procedure: Crank the bed up so you aren't leaning over all the time. Seriously. You iwll kill your back otherwise.

 

[DOtobe]

A-lines are the bane of my existence. It seems like every a-line I do, I get the flash but then can't thread it. I've had to have one of the senior residents help me each time I do an A-line.

The only advice I have is to look for the spot where the nurse/whoever stuck for the ABG if you can't feel a pulse. It's like a sign that says "stick needle here."