Pendahuluan

Arterial Puncture with

a Needle/Syringe

DIDALANYA ADA
LAPISAN heparin
litium kering
Tarikannya
memungkinkan udara
keluar saat darah
masuk.
Untuk menggunakan
spuit ini tarik dahulu,
baru di tusukkan ke
arteri
Klo udh masuk ke
lumen, dy naik
sendiri

Equipment for Insertion and

Maintenance of an Indwelling
arterial canuls
Antiseptic solution
1% lidocaine (without
epinephrine); usually
2 to 3 mL delivered
by a 25- to 27-gauge
needle is required for
adequate anesthesia
of the cannulation
site

Syringes (3 and 5
mL for anesthesia,
5 mL for aspiration)
10- 10-cm
dressing sponges
Arm board for
brachial, radial, or
ulnar cannulation

Catheters for arterial

cannulation. A, Standard
intravenous
catheter. Use 20 gauge for the
radial artery and 16 or 18
gauge
for the femoral artery. B, Arrow
Arterial Catheterization Kit.
This
device has a self-enclosed
guidewire that is advanced into
the artery
by moving the actuating lever
forward. When the lever
reaches
the reference mark on the
barrel of the device, the tip of
the guidewire
is at the opening of the needle
lumen.

teknik

1. Position the wrist in slight

dorsiflexion, cleanse the skin
with
antiseptic solution, and palpate
the radial pulse.

Teknik

2. Optionally, place a small

wheal of local anesthetic (e.g.,
1%
lidocaine without epinephrine)
over the entry site. Avoid
placing
too large of a wheal, which
may obscure the artery.

3. Hold the syringe in your

hand like a dart, with the bevel
up.
Palpate the artery with the
index and middle fingers of
your other
hand. Puncture the skin distal
to your finger, and slowly
advance
the needle at a 30 angle
toward the pulsating vessel.

4. As soon as blood flows, stop

advancing the needle. Allow
the
syringe to fill on its own. If
bone is encountered, withdraw
slowly
because both vessel walls may
have been penetrated and the
lumen may be entered as the
needle is withdrawn.

5. Remove the needle from the

artery after the syringe has
filled.
Apply a bandage and firm
pressure to the puncture site
for a
minimum of 3 to 5 minutes.

6. Remove all air from the

syringe by holding it upward,
gently
tapping it, and depressing the
plunger. Attach the end cap to
the
syringe to maintain anaerobic
conditions, and submit the
sample
to the laboratory.

Placement of the transducer

over the distal end of
the arm in the transverse
plane to localize the radial
artery.

Image of the radial artery with

color flow. Applying color flow
will enable the operator to
correctly identify the
artery.

ARTERIAL
CANNULATION: OVERTHE-NEEDLE
CATHETER
TECHNIQUE

1. Immobilize the hand and

wrist in mild dorsiflexion on a
padded
arm board. Prepare the skin
with antiseptic, anesthetize,
and
apply a sterile drape.

2. Advance the needle into the

artery at a 30 to 45 angle to
the
skin. Confirm arterial puncture
by observing a flash into the
needle hub.

3. Lower the angiocatheter and

advance it 2 mm forward to
ensure
that the tip has cannulated the
vessel. Confirm proper
placement
by observing continuous
arterial blood return.

4. Carefully advance the

catheter over the needle and
into the
artery. Do not force the
catheter; if it fails to easily
thread, it has
not properly entered the vessel
lumen. (See text for
troubleshooting tips.)

5. Tamponade over the artery

proximal to the tip of the
catheter (to prevent blood
loss), and remove the needle.

6. Attach the tubing from the

pressure transducer to the
catheter. Suture the catheter
hub to the skin and cover with
a sterile
dressing, such as Tegaderm.

komplikasi

Right groin hemorrhage with

resulting hematoma.
The injury resulted from a
failed attempt to place a right
femoral
artery catheter via the
Seldinger technique. A large
femoral hematoma
is pictured here 3 days after
iatrogenic injury.

interpretasi

Kesimpulan