Arterial Line Set Up in the ED
Summary
TLDRThe 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
🛠️ 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.
🩺 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.
Mindmap
Keywords
💡Radio
💡Transducer
💡Pressure Bag
💡Arterial Line
💡Transit Circuit
💡Prime
💡Vented Cap
💡Flush
💡Pressure
💡Zeroing
💡Systolic and Diastolic Pressure
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
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