2011 OPEN FORUM Abstracts
THE EFFECT OF BLOOD PRESSURE ON RCP ULTRASOUND GUIDED ARTERIAL CANNULATION SUCCESS RATES.
Andrew Miller, Andrew Almond, Jhaymie Cappiello, Michael Gentile, Janice Thalman, Neil MacIntyre; Duke University Hospital, Durham, NC
Background: Conventional radial arterial line placement requires locating the desired vessel by palpation. The use of ultrasound guidance for radial artery cannulation has been shown to improve success rates, reduce the overall time to successful cannulation, and to facilitate training. We sought to analyze systolic blood pressure, pulse pressure, and palpable pulse strength in relation to ultrasound guided radial artery cannulation success rates. Methods: RCPs certified in arterial line insertion were trained in radial artery catheterization using ultrasound by Emergency Medicine physicians. After obtaining IRB approval for this study, patients were enrolled based on the need for an arterial line placement. The catheters used were Sharps Radial Artery Catherization Set with a 20 gauge catheter, 22 gauge introducer wire, and spring wire guide with integral needle protection. The ultrasound devices were the Sonosite iLook and the Sonosite MicroMaxx. Data recorded included strength of pulse, systolic and diastolic blood pressure, number of attempts (3 or less punctures per attempt), successful/unsuccessful artery cannulation. Catheterizations were performed according to institutional policy and procedure. Results: This review covers a 28 month period (12/08- 4/11). The age of the patients was 56 +/- 14 years. Their systolic blood pressure was 101.5 +/- 31.5 mmHg. There were a total of 108 attempts at cannulation with 92 arteries successfully cannulated. Conclusion: Blood pressure and pulse pressure are not reliable predictors of success for ultrasound guided radial artery cannulation. Palpable pulse strength is the strongest predictor of success.
Sponsored Research - None
Success Rate = Successful attempts/Total attempts