Arterial Cannulation: Indications, Procedure, and Risks

In the critical care unit, a second not only matters, it decides the life and death of a patient. At the moment, a simple mistake can not be made. Every decision should be taken with precision. Here’s where arterial cannulation helps. It allows doctors to take the right action at the right time.

In arterial line placement, doctors insert a sterile catheter into an artery. It allows professionals to monitor blood pressure continuously and take blood samples if needed. It offers high accuracy and minimum risks.

In this blog, we will share everything about arterial catheterisation. You will know what it is, how they insert arterial cannula and what the risks are. So, let’s get into it!

What Is Arterial Cannulation?

The arterial cannulation is used to monitor blood pressure and take arterial blood samples. It helps to measure blood pressure accurately. The infusion process is used in emergencies and critical situations. It is a safe technique with low risks and complications.

In addition to that, an arterial cannula helps doctors to monitor blood pressure in real time. It allows them to respond quickly and keep track of any sudden changes in a patient’s health and condition.

Learn more about what is cannulation with our detailed blog! 

Key Purposes of Arterial Cannulation

Arterial cannulation is also known as arterial catheterisation or arterial line placement. It is the best way to monitor blood pressure in real time. The cannulation is only used in emergencies to save more lives.

Here are some key purposes of arterial line placement:

• Continuous Blood Pressure Monitoring: The primary purpose of arterial catheterisation is to monitor blood pressure in real time. It helps to know the accurate blood pressure in critical situations.
• Arterial blood sample collection: The cannulation process is also used to collect blood samples from arteries. It allows for testing arterial blood gas (ABG).
• Medicine effect monitoring: Another with that catheterisation helps to monitor the medicine effect. In this way, medical staff can track the immediate response of medicines.
• Critical care management: An arterial cannula helps in making decisions in critical situations for emergency patients.
• Pre and post-surgical monitoring: The cannulation process helps to improve pre and post-surgical patient health monitoring. It ensures the patient’s health stability in any condition.

Indications of Arterial Cannulation

The arterial cannula is mainly used in critical cases. It allows continuous blood pressure monitoring and sample collection. Here are the indications when doctors use arterial line placement:

• Major surgeries: Generally, medical staff recommend arterial cannula insertion after any major surgeries. So they can monitor the blood pressure in real time and take action accordingly.
• Frequent ABG analysis: For patients who need regular monitoring for oxygenation and ventilation, doctors allow arterial catheterisation.
• Critically ill patient: Arterial line placement is also a much-needed technique for critically ill patients. The cannulation process helps in hemodynamic monitoring.
• Hypertension: The cannulation helps in hypertension. It helps doctors to keep track of patient’s health and condition in real-time.
• Use of vasoactive medications: When doctors push medicines that affect blood pressure, the arterial line placement helps a lot.

How Is Arterial Intubation Performed?

The process of arterial cannulation starts with inserting a thin and sterile catheter into your artery. However, the radial artery at the wrist is used most commonly. To reduce the infection risk, arterial line placement is performed under sterile conditions. To make the area insensitive to healthcare professionals, they use local anaesthesia.

The arterial catheterisation process goes through three steps. Let’s break down the three common steps-

Preparation

At the beginning of arterial cannula insertion, the doctor describes the whole method to the patient. Along with that, the healthcare professional gets consent from the patient to start the process. To minimise the risk, they review the patient’s medical history, bleeding tendencies, and anticoagulants.

For testing adequate blood flow in the radial artery, doctors use Allen’s test. Before that, they rub the skin with antiseptic to keep the area disinfected.

Insertion Process

After preparation, regional anaesthesia is injected to anaesthetise the area. Using Alta Sound, the artery is palpated or visualised. Then, a needle is inserted into the artery deeply to confirm pulsatile blood flow.

Furthermore, a guidewire is placed through the needle. And then, a catheter is installed over the needle directly. Also, the catheter is flushed with saline and made secure with an adhesive dressing. Finally, it is connected to a monitoring system for continuous readings.

Post-Procedure Care

Upon successful cannulation, the area must be checked for signs of infection, bleeding, or impaired blood flow. The waveform evaluates to ensure an accurate reading. Together, the catheter is flushed continuously to prevent blood clotting.

By the way, the cannula should be removed after completing the arterial catheterisation process. While removing the cannula, intense pressure is applied to prevent bleeding. At the end, a sterile dressing is a must. It is mentioned that the monitoring process must continue to avoid hematoma, infection, or thrombosis, etc.

Why Is Arterial Cannulation Used?

Arterial infusion is used for monitoring accurate and continuous blood pressure. Additionally, the process is applied to patients undergoing major surgeries. The process helps doctors administer the correct amount of fluid to the patient without disruption.

Moreover, arterial catheterisation allows for the close monitoring of patients with conditions such as low blood pressure, organ problems, and infections. For being the method, healthcare providers can make the right decision in a short time in critical situations.

• Clinical Applications

With arterial line placement, medical staff can monitor blood pressure closely. In the meantime, they can manage it without trouble. Providing the right amount of fluid and anaesthesia for a patient’s arterial cannula works like magic. Arterial line placement is mostly used for the treatment of patients in the ICU or critical care units.

Advantages Over Alternatives for Arterial Cannula Insertion

The arterial catheterisation offers several benefits over other alternatives. It is a much more reliable and quick process than non-invasive methods. Generally, we use the cuff-based blood pressure monitor or the traditional blood draw to monitor BP and health. On the other hand, arterial intubation helps to check the data accurately and monitor continuously for critical care.

Here are the benefits of the arterial line placement:

• Continuous monitoring: The technique helps to monitor blood pressure from time to time. With the data, doctors make an accurate decision for the patient.
• High accuracy: Arterial infusion is a more reliable and non-invasive method. So, it provides high accuracy for critical patients.
• Better medicine management: It also works amazingly for medicine management. Therefore, doctors can manage the drug dose that affects blood pressure.
• Easy ABG access: The line placement gives doctors easy access to arterial blood. So they easily get the ABG tests done and prescribe accurate medicine.
• Essential for critical care: It helps in managing shock or multi-organ failure. With cannulation, the medical staff keeps an eye on the emergency patients and saves lives.
• Reduce needle risk: Together with that, the process allows to reduce the needle punctures to collect blood samples. So, it is a safe technique for critical care patients.

What Are the Risks and Complications of Arterial Cannulation?

The arterial catheterisation is a reliable and safe technique for patients. It offers a lot of benefits to the modern healthcare industry. However, it has some risks and complications. Doctors and healthcare professionals always take proper steps to avoid and reduce the chances of any complications.

Here are some of the risks of arterial cannula insertion:

• Infection: The arterial line can become a local site for infection if it’s not well maintained. Sometimes, bloodstream infection can occur due to poor hygiene.
• Thrombosis: It means blood clot formation in the artery and the cannulation site. It blocks the site and hampers the blood flow.
• Hematoma: It refers to bleeding and bruising at the insertion site. Also, it causes swelling, pain and discomfort for the patient.
• Embolism: Arterial line placement increases the chance of embolism as well. Although it is rare, but it can be life-threatening.
• Neurological Complications: The catheterisation can also lead to some neurological complications. It can damage nerves, cause sensory impairment and even nerve paralysis.

Conclusion

Arterial cannulation plays a very important role in saving lives in the emergency situation. It includes placing a catheter in the artery and monitoring blood pressure. It is a safe and highly effective procedure to save lives during major surgeries and in ICU.

In addition to that, the arterial cannula allows to collect blood samples and make the accurate decision for the patient. With a better understanding of uses, benefits and risks, doctors do their best to save the lives of critical care patients.

FAQs

Does arterial cannulation hurt?

Yes, the arterial line placement procedure is a bit painful. The cannulation includes inserting a catheter into the artery. And the arteries are deeper than veins. So, it is more painful than other cannulations. However, the medical staff uses pain management techniques to ease the pain. Mostly, they prefer local anaesthesia to minimise the discomfort and pain for the patient.

How long can an arterial catheter stay in place?

The arterial catheter can stay 5-7 days in a place. However, it depends on the patient’s condition and insertion site. The doctors remove it as soon as it is not needed. Moreover, healthcare professionals monitor the site regularly to prevent any risks and infections. According to York Perioperative Medicine Service, the line must be changed in every 72 hours to reduce the risks.

Why is the radial artery commonly used?

The radial artery is commonly used for its easy accessibility and superficial location. It also has lower risks and complications than other cannulation processes. Another with, the radial artery offers good collateral circulation through the ulnar artery.

Can arterial cannulation cause permanent damage?

Even though it is relatively rare, arterial cannula insertion can cause permanent damage. Complications like infection and hematoma can sometimes occur due to management or mechanical issues. But, permanent hand ischemic damage happens in 0.09% of situations (Reported by NCBI).

What’s the difference between arterial and venous cannulation?

The main difference between arterial and venous cannulation is the intended purpose and accessed blood vessels. The arterial cannula is placed in the artery to measure blood pressure. On the other hand, venous cannulation is placed in a vein to push medicines directly to the bloodstream.

What to Read Next:

• How to Become a Childminder – A Complete Guide
• 8 Examples of Illegal Moving and Handling Techniques in Health and Social Care
• What is Duty of Candour? Professional and Ethical Guidance at a Glance
• How to Become a Phlebotomist?
• How to become a Nurse in the UK? – Step by Step Guide
• What are the Types of Observation in Health and Social Care? 6 Important Types
• How to Get Phlebotomy Certification?