Arterial Line Set Up in the ED

Summary

The video script provides a detailed tutorial on setting up and using an arterial line for monitoring blood pressure. It covers assembling the necessary equipment, including a transducer, pressure bag, and arterial catheter, and the steps for priming and flushing the system. The process of zeroing the transducer, attaching it to the patient, and calibrating the monitor for accurate blood pressure readings is also explained, ensuring a sterile and precise method for critical care.

Takeaways

• 📻 The video script discusses the setup and use of a radio for communication in a department, possibly a medical setting.
• 🔍 A variety of supplies are needed for the setup, including a copper millisecond transducer, a pressure bag, and equipment for radial artery access.
• 🩺 The script mentions the use of longer catheters for radial artery access, indicating a preference for equipment suited to specific medical procedures.
• 🧵 The process includes inserting a catheter and using a 'big Tegaderm' for covering, suggesting a focus on maintaining sterility and integrity of the inserted device.
• 🔌 The script describes connecting the radio to a circuit and grounding it, indicating the importance of proper electrical setup for communication devices.
• 💧 A detailed explanation of priming the pressure bag with saline solution is provided, highlighting the need for removing air and ensuring proper fluid flow.
• 🩹 The script emphasizes the importance of 'burping' the bag to release trapped air, which is a critical step in preparing medical equipment for use.
• 🛠️ The process of attaching and securing the catheter to the patient is described, including the use of sutures and sterile techniques.
• 📊 The script explains how to calibrate and zero the pressure transducer, which is essential for accurate monitoring of arterial pressure.
• 📈 Adjustments to the scale for better visualization of blood pressure readings are mentioned, showing attention to detail in monitoring patient vitals.
• 🔬 The final steps involve connecting the transducer to the patient and ensuring it is level and properly calibrated for accurate readings.

Q & A

What is the main topic of the video script?

The main topic of the video script is the setup and use of an arterial line, including the equipment needed and the process of preparing and using it in a medical setting.

What type of equipment is mentioned for setting up the arterial line?

The equipment mentioned includes a copper millisecond transducer, a pressure bag, a pressure transducer, and a Tegaderm dressing.

What is the purpose of the Ark Encounter mentioned in the script?

The Ark Encounter is likely a term used for accessing the radial artery, which is necessary for the insertion of the arterial line.

Why is a longer catheter preferred for arterial line insertion?

A longer catheter is preferred for arterial line insertion to ensure proper placement and to facilitate the monitoring of arterial pressure accurately.

What is the significance of the 'work rent' mentioned in the script?

The term 'work rent' seems to be a mispronunciation or typo, and the context does not provide a clear meaning. It might be related to a specific medical term or procedure that needs clarification.

What is the purpose of the 'big Tegaderm' mentioned in the script?

The 'big Tegaderm' is used to cover and protect the insertion site of the arterial line, providing a sterile barrier to prevent infection.

What does the script suggest doing with the saline solution in the pressure bag?

The script suggests 'burping' the bag, which means to release any air trapped in the saline solution within the pressure bag to ensure accurate pressure readings.

Why is it necessary to prime the arterial line before use?

Priming the arterial line ensures that there is a continuous flow of saline solution through the line, which is crucial for maintaining accurate pressure readings and preventing air bubbles that could affect the readings.

What is the purpose of the caps with vents and without vents mentioned in the script?

The caps with vents are used during the setup and priming process to allow air to escape. Once the system is ready for use, the non-vented caps are used to prevent air from entering the system and to maintain sterility.

How is the pressure transducer calibrated in the script?

The pressure transducer is calibrated by attaching it to the patient's chest at the level of the heart, zeroing it, and ensuring that it is connected to the arterial line to accurately measure blood pressure.

What is the importance of the 'octave in scale' setting mentioned in the script?

The 'octave in scale' setting is used to adjust the display scale of the blood pressure monitor so that the readings are more easily visible and accurately represented on the monitor.

Outlines

00:00

🛠️ Setting Up for Intraoperative Monitoring

This paragraph outlines the process of preparing for intraoperative monitoring using a radio. The speaker discusses laying out necessary supplies, including a copper millisecond transducer, a pressure bag, and equipment for radial artery access. They emphasize the importance of having the right tools, such as longer transducers, and the need for a work rent. The paragraph also covers the initial setup of the radio, including attaching a general purpose break and grounding. The speaker mentions the use of a Tegaderm for protection and the steps to prime the transducer, including burping the bag to remove air and ensuring the saline is properly started. The focus is on the meticulous preparation required for accurate and safe monitoring during surgery.

05:02

🩺 Attaching and Zeroing the Argon Pressure Monitor

In this paragraph, the speaker describes the procedure for attaching and zeroing an argon pressure monitor. They start by flushing the system to ensure there are no air bubbles around the position. The catheter is prepared in a sterile manner, and the physician sews it in place. The use of larger syringes for flushing is recommended over smaller ones. The speaker also explains how to set up the monitor, including activating the pressure transducer and adjusting the label to match the device in use. The process of zeroing the monitor is detailed, which involves placing the transducer at the patient's chest level, using foam tape for secure placement, and ensuring the transducer is zeroed before the patient is connected. The paragraph concludes with instructions on optimizing the scale for better pressure readings, including adjusting the scale range to match the patient's blood pressure.

Keywords

💡Radio

In the context of the video, 'radio' refers to a communication device used in the medical setting. It is essential for coordinating and communicating with team members during procedures. The script mentions setting up the radio, indicating its importance for effective communication in the department.

💡Transducer

A 'transducer' in medical terms is a device that converts one form of energy into another, commonly used to convert pressure into an electrical signal. In the video, it is used in conjunction with a pressure bag to measure arterial pressure, highlighting its role in monitoring a patient's vital signs.

💡Pressure Bag

A 'pressure bag' is a component of the arterial monitoring system, used to maintain a constant pressure around the transducer. The script describes the process of setting up the pressure bag, emphasizing its importance in ensuring accurate pressure readings.

💡Arterial Line

An 'arterial line' is a catheter inserted into an artery to monitor blood pressure directly or to draw blood samples. The video discusses the preparation and insertion of an arterial line, showing its critical role in patient monitoring and treatment.

💡Transit Circuit

The 'transit circuit' mentioned in the script is part of the arterial monitoring setup, used to connect the arterial line to the transducer. The video explains the process of preparing and using the transit circuit, underlining its function in the arterial pressure monitoring system.

💡Prime

To 'prime' in this context means to fill the system with fluid to prepare it for use. The script describes priming the boards and the pressure bag, which is necessary to remove air and ensure the system is ready for accurate readings.

💡Vented Cap

A 'vented cap' is a type of cap that allows air to escape while preventing contamination. The video script mentions switching from vented caps to non-vented caps after priming, which is a step in preparing the system for patient use.

💡Flush

To 'flush' in a medical context refers to clearing out the system of air and ensuring that fluid flows freely. The script describes flushing the arterial line, which is crucial for preventing air embolism and ensuring accurate pressure readings.

💡Pressure

In the script, 'pressure' refers to the arterial blood pressure being monitored. The video details the steps to set the correct pressure for the monitoring system, illustrating the importance of accurate pressure measurement in patient care.

💡Zeroing

The term 'zeroing' in the script refers to the process of calibrating the pressure monitoring system to the patient's level. This is done to ensure that the readings are accurate and reflect the patient's actual blood pressure.

💡Systolic and Diastolic Pressure

These terms refer to the two measurements of blood pressure: 'systolic' is the pressure when the heart beats and pumps blood, while 'diastolic' is the pressure when the heart rests between beats. The script mentions the importance of these measurements for assessing a patient's cardiovascular health.

Highlights

Introduction to setting up a radio for departmental use and potential temple use.

Laying out supplies needed for the radio setup, including a copper millisecond, transducer, and pressure bag.

Requirement of an Ark Encounter for radial arteries, with a preference for longer ones.

Mention of finding all art sites and the need for work rent.

Instructions on setting up the radio with a general purpose break.

Grounding the Republic with broad waters for safety reasons.

Demonstration of setting the radio in a pressure bag and preparing for use.

Explanation of the transit circuit used for competing and its accompanying caps.

Priming the boards before changing to non-vented caps.

Cleaning the roller printer and burping the bag to remove air.

Procedure for cutting the hole puncher and attaching caps to the bag.

Flushing the amount before changing caps to prepare for patient use.

Technique for applying pressure to the bag and monitoring the green indicator.

Ensuring the pressure is maintained before catheter insertion.

Flushing the system one more time before catheter insertion for safety.

Connecting the catheter to the arm line and ensuring sterility.

Setting up the Heartland table and monitoring system for arterial pressure.

Activating the commentator and adjusting the transducer for arterial pressure monitoring.

Zeroing the transducer at the patient's level for accurate readings.

Optimizing the scale for better visualization of systolic and diastolic pressures.

Transcripts

so today we're going to kind of go over

around we said and our peril hood here

at this department and old touchline

each day we're going to use the radio

but potentially on a temple

so we've got our supplies laid out here

or we're going to need I'm just going to

go over the radio or worse

so actually get your set up ready to go

you're gonna need a copper millisecond

transducer it in a pressure bag and then

the position we'll need the Ark

Encounter for the radial arteries they

usually prefer use longer ones and all

of this have to be found in to fix this

over here for the most part this is

where all of your art wants I was going

to be and also need the work rent and

then after insertion I'm still sewing in

usually they're going to use it oh so

this is for a limited market silver

about match and then a big Tegaderm to

go over this as well for radio r1 so

usually if everyone it on board as well

keep everything to be started every

circuit yet just sew it in leave a

general purpose break it as well

then I usually ground Republic several

broad waters just because it can be

nobody so it's more actually and I

usually go ahead and just set it in a

pressure but you're not in it like that

just yet

you need to say that forever old you can

access

this transit circuit is the one that we

usually use competing and it will come

with caps I've got vents on them I don't

know you can kind of see they don't come

with these clear woods here that

actually have in that moment before you

actually use it on the patient you're

going to switch out to these little

white caps here that don't have it then

but you'll have to prime each of your

boards first before you change those out

the guy had never been outside

so you'll get your kids that go ahead

and clean off your roller printer

[Music]

and once that thing is I remember to do

is you actually need to burp your bag

see usually don't find what you're in

them so you need to kind of her better

out so you're gonna open up your clamp

and you're just going to kind of squeeze

they are out on this bag here

because you have to do it and also

they can get it to start tripping saline

in there

and once you can get that air out of the

bag then you can go ahead and the rest

of your art - so to do that even when

this tab is closed or open even when

it's no good and you'll have to pull

this hole puncher and actually find the

bag so I like to go ahead and just cut

everything all the way in and then have

fun than that in caps as well so you'll

just pull the plunger - you see it kind

of rolling through here you'll find it

all the way to a drip

after you do that the next step that you

need to do is before you change out

these caps you need a flush amount so

you're going to turn it off away from

the cat and you want to open to the bag

because that's we're gonna prep it out

something you're gonna prime it to where

it is sports out there turn it off and

you'll remove this and you'll replace it

with a non-vented cap and then there's

actually one more down here you have to

do the same thing to so you'll turn it

off towards the patient's side and off

is going to be whichever direction this

is pointing I'm going to prime this one

more time

turn it back off to the cat

and you kept one so at this point when

you're going to leave these off to these

caps from now on until you see so then

you'll need to go and employ our

pressure and to do that make sure you

flip this door it's open here

and you're gonna pump it up smooth like

a man

but you'll want to come in at door you

see green coming out just gives me

around 300 millimeters of mercury

so you can start seeing the great come

out there the last thing you need to

remember to do once you get your

pressure 40 point is you have to split

this off to the bag otherwise it's going

to slowly leak out of here you're gonna

lose your pressure and this needs to be

pressurized before the position and

Germany's inserted once I have

everything kind of set that a crime

right before we hook it up at argon I

usually just flush more time just make

sure that we've got all the way around

the positions at that point this will be

their catheter and the way you can

Pacific facilitate pumping

have a poor memory for them to kind of

prep very amazing and once they get the

catheter Hannibal in the oil in this

tonneau this needs to be sterile so you

can twist this off and just make sure

that you keep it into this clean and

sterile while they're hooking it up to

the arm line the physician will usually

sew it in place and about October that's

and then one of the big tech Turner's

and these are better just for figuring

everything than the small ones but you

could use this moment of engine you can

access and these with these should be

and all of your own parts and in your

compost as well

and then after that your Heartland table

so on these monitors here the art on

campus is going to go into this pressure

transducer we have one that is tunnels t

OT ones you may have an extra transducer

available to you

that doesn't really run over 20 years

just as long as you activate the

commentator so to do that you'll see

what this monitors up click here and it

has this on ICP right now actually so

you can click that your pressure

transducer will change the label to our

mine and then activate so that point

this is ready to go ready for you don't

get up to noon so once the position has

this hooked up to the patient you will

plug in the transducer this here the

flush needs to be at the level apart

what we normally do down here is we'll

tape it to the patient's chest whichever

side is going to be the most out of the

way you can do right over left and the

best way to do that is to use the foam

tape the other tape is going to kind of

move around too much and the foam tape

does a really nice job with kind of

cutting it and keeping it rolling around

too much on a patient

so once you have this on the patient's

chest and everything to hook that you'll

need to see over here our time so to do

that it really must have a second person

to do this but you can just do the CRO

and then hit Sierra art and what you'll

do when you do that is you're going to

put this off to the patient and so this

is your paycheck on here so you'll turn

your court off to the patient you will

go up into here

you're going to wait for it to be the

second time once it needs a second time

your zero and you can go ahead and put

this back on and make sure you open it

and back up to this valve here so what

you should get at that point this

doesn't hook up to the patient but you

should have a nice kind of s-waves

showing that pulse on here and it's kind

of a good mimic without that but it

should have a nice kind of sine wave

that correlates with what their heart

rate is and the other thing that you may

need to do whether pressure disease you

may need to optimize the scale so you

can actually see the weight for better

to do that you're just going to click on

our line

you're going to scroll down and you're

going to hit octave in scale and what

that's going to do right now that's

going between 0 and nad no here summer

if their pressure is much lower than

that and this will make that scale a

little bit smaller so you can either

wait for better and then it should spit

out your systolic diastolic pressure

meter that's it