The Arterial Line Assessment & Troubleshooting!

[@ICUAdvantage]

The lesson notes (as well as other perks) are available to the KZbin and Patreon members! Join now at the links below! Patreon membership: adv.icu/3A3m8yO KZbin membership: adv.icu/3C4fiuR

[@andy1payne]

awsome series thanks! none of the nurses on my unit could explain to me what a square test was, so thank you for being there when they couldnt!

[@ICUAdvantage]

Truly glad to be able to help Andrew!

[@michaelquarshie3466]

This was very useful, especially tonight. My patient’s A line waveform began to flatten out of nowhere. My initial thought was low pulse pressure. I watched this video which taught me how to do a square wave test, then zeroed, then checked the alignment to make sure the transducer was at phlebostatic axis, all to be certain it wasn’t a problem with the A line. Turned out I was right.

[@ICUAdvantage]

Awesome to hear this! Thats exactly why I make these. To try and give people the knowledge they need to be success and ultimately to be able to help the patients. Really glad you were able to make use of this info and advocate for your patient.

[@elizabethdiaz9720]

This was such a thorough review. I love love love your videos. Thank you so much ❤

[@ICUAdvantage]

Really glad to hear this Elizabeth! This series is one of my favorite :)

[@DrRussell]

Fantastic work Sir

[@munaabed8336]

Great explanation! I need to ask you about the patient's position (e.g. lateral position, high Fowler's position) and its relationship to leveling and accuracy of BP readings. Thanks!

[@baileybunsen8044]

Awesome job! as a new civic nurse I greatly benefit from your videos. If possible could u maybe go over stopcocks ?

[@dhruvipatil4353]

Best explaination

[@DarshanaRokade-mh6tb]

Wonderful wonderful explanation, Thank you so much for explaining in such an amazing way . Question - why to keep 300 mm hg pressure in the pressure bag??

[@emiato8850]

Maintains pressure bag at 300mmHg to deliver 3-5ml per hr of flush solution to prevent clotting and backfliw of blood

[@LifeRNhungrynursetravels]

This is great! Thanks for the overview!

[@ICUAdvantage]

You're welcome! Glad you enjoyed the lesson.

[@rosswillison6730]

Thank you Eddie for these excellent educational videos. I really appreciate it. Quick question, where did you get the information about it not mattering where the transducer is located when zeroing the ART line? I tried explaining this to some colleagues, but would like to back it up with a reference. Thx. Also could you discuss the reasonihg behind using a separate extension line w a stop cock and why you hand it to the MD separately from the pressure line itself? Thx.

[@shaimaa6780]

perfect explanation 🤩 thank u

[@ICUAdvantage]

Awesome. Glad you enjoyed it!

[@isabelhovig]

My patient’s wave was over damped, and everything on this checklist was fine. For the square wave, I did a hard flush at the stop cock closest to the pt. It would whiten the palm of his hand and send searing hot pain into his wrist/hand for a few seconds (but the hard flush corrected the wave form and BP reading). What could have the palm pallor & pain indicated?

[@Flippinpinoy09]

@5:15 we use those Velcro foley straps to keep the transducer at phlebostatic axis. We use it for a lines more than foleys in my ICU lol Works great

[@ICUAdvantage]

Hey whatever works! What do you velcro it to?

[@Flippinpinoy09]

@@ICUAdvantage the strap Velcro onto itself

[@slgallow]

Our policy is to Velcro the transducer to the patient’s upper arm

[@wesamzaen5463]

Great as usual, I worked in cardiac surgery unit for 4 years , still you adds a lot to me. Thank you.

[@joshmccord9507]

Do you have any videos on insulin drips and what all needs to be corrected before the drip can be discontinued??

[@ICUAdvantage]

Not yes, but it is on the todo list

[@SuperMCKlappstuhl]

Great Content, Thank you! 😊What's your opinion about removing a clot from an arterial line via a syringe?

[@ICUAdvantage]

Thank you. And I don't think I've ever seen that done. I wouldn't imagine it would be too easy to do either as the catheter is quite small. If its clotted off, probably just need a new one.

[@SuperMCKlappstuhl]

@@ICUAdvantage To be honest, I did that just recently, but it was a freshly inserted FlowSwitch 20G, not older than an hour. I observed that the arterial system wasn't showing any blood pressure, saw that there's no pulsating at the tip of the arterial canula, so I put the FlowSwitch on "off", disconnected the system, put on a 2ml syringe, put it back on "on", withdrew 2ml of blood, back on "off" , connected the arterial line back, "on" again and put the system back in place. En voilá! We had a pulsating system and a blood pressure on our monitor. To be honest, this was more a hunch than a scientific backed decision, but it worked. I guess it has to be done as fast as possible.

[@slgallow]

Thanks for the great video! I’m wondering, is a “whipped” waveform the same as an under damped one or is that something different altogether?

[@ICUAdvantage]

Same thing! Glad you liked the video

[@guitarloungechannel]

You rock!

[@ICUAdvantage]

Thanks Milton!

[@KCZ94]

Sir, as u have clearly explained that there well be a changes in blood pressure with change in the level of the transducer with respect to the phlebostatic axis. Can you please tell if there will be any changes in blood pressure recording if the site of cannulation is kept above or below the level of the phlebostatic axis?

[@ICUAdvantage]

Nope. The insertion site doesn't matter, just make sure you keep the transducer at the proper position.

[@mbalimamba5729]

Thank u

[@ICUAdvantage]

You're welcome

[@themindsetsecret]

Hi thank you so much for this, amazing help!! I just have a stupid question- pressure bag is supposed to be 300mmhg to prevent backflow. I got that but why 300? It delivered 3mls/hr flush but why 300?, it could be 200 or 250?? Lol I just can't find any answer for this. Could you please help me? Thank you so much!

[@ICUAdvantage]

I don't know if I have an answer for that question. I'm not entirely sure!

[@1ayhrhish]

Do PA line please.

[@somzm8037]

Pleaaaase!

[@nimochoudhary6265]

Assalamualaikum. Edy sir. Well defined as usual. 👍❣️

[@ICUAdvantage]

Appreciate that! Glad you liked the video. Thank you.

[@riveriajamming]

what happens in the case of leveling transducer to the tragus in the case of TBI?

[@ICUAdvantage]

I think you're thinking of the transducer on the EVD and not the art line. Different concepts which I'll eventually get around to when I cover EVDs.

[@riveriajamming]

@ICUAdvantage nope definitely not. We position arterial line transducer at tragus level for traumatic bleeds and measure BP from tragus level

[@gracep2910]

Is there any chance you could do more PICU-specific videos? Thank you!

[@ICUAdvantage]

Unfortunately I just don't have any experience there.

[@josephcapucetti519]

Amazing content. Do you have a Patreon to support??

[@ICUAdvantage]

Thank you so much Joseph! Really glad you are liking it. I do have a Patreon, but it looks like you are a KZbin member. There are some different tiers on Patreon, but the $5 Patreon is the exact same as the KZbin membership.

[@janearc5788]

Hi Eddie, I love all your videos. I also wanted to know where do you place the transducer when the art line is located in femoral artery. Thanks

[@ICUAdvantage]

Same spot. Phlebostatic axis regardless of insertion site.

[@RandomGrump]

Lol no one talkin about the HR at 33?

[@ICUAdvantage]

Its fine. Its fine! 😂

[@MaddyLee99]

They do that sometimes when they sleep 😂

[@Pokedawn100]

That's A LOT! Lol

[@ICUAdvantage]

Haha true 😊