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Direct Arterial Pressure Monitoring
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Kristin Spring, CVT, VTS (Anest), explains the calibration, use, and care of a direct arterial blood pressure system.
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Kristin Spring
CVT CVPP, VTS(Anes.), VTS(ECC)
Enrolled: 08/2011
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Can you please tell me why a T-Port should not be attached to the catheter? Your directions say not to, but do not give a reason.
Also, Is it ok to attach an additional 3-way stopcock to the catheter instead, and then attach the transducer tubing to that?
Hi Emily- good questions. When we are using a transducer set-up to measure direct blood pressure, we don't typically use a T-port. Adding a T-port could change your readings and decrease accuracy because of the narrow tubing with the 90 degree turn on the arm of the T-port. We also don't put a 3-way SC directly into the catheter. I'm not convinced that it would change your DBP readings, but I would be concerned with the extra weight and bulk that it puts on the arterial catheter. We know art-lines can be a bit fickle and come with increased risk of injury to the patient if inadvertently disconnected. If you have a patient on direct blood pressure monitoring and you need to obtain a sample for an ABG, we use the 3-way stop-cock included in the transducer set-up and obtain the sample using the 3-syringe technique. Hope this helps!
I have always been taught to have the flush bag made of heparinized saline to decrease the chance of your arterial line clotting. Is hep saline not required, do you find that your catheters clot when using plain saline?
Hello Kimberly - Arterial catheters may be more likely to clot without heparin, but straight saline can be adequate depending on the frequency you are flushing. Heparin is not a completely benign medication. Frequent flushing with heparinized saline in art lines used over several days could potentially lead to a hypocoagulable state if you’re not careful, especially with smaller patients. Ultimately, be thoughtful about whether or not to include it and customize it to the specific case you are working on.