Arterial cannulation – Procedural Competences

FRCEM EXAM QuestionsCategory: December 2016Arterial cannulation – Procedural Competences
FRCEM Intermediate Staff asked 2 years ago
You are working on an intensive care unit when a patient is admitted from an emergency department following a large mixed overdose. Your consultant asks you to insert an arterial radial line.

A. Give (2) indications, (2) contraindications? (1 marks)
B. Give (2) complications? (1 marks)
C. After inserting an arterial line, you note the trace is inadequate. Give four reasons for inadequate arterial tracing?

1 Answers
FRCEM Intermediate Staff answered 2 years ago
A.
Indications

  1. Continuous beat-to-beat heart rate and blood pressure monitoring.
  2. Frequent blood sampling without the need for repeated arterial puncture.
  3. Frequent arterial blood gas sampling.
  4. Inotropic (or vasopressor) support
  5. Monitoring of waveform for cardiac output and end-diastolic volume estimation.

Contraindications

  1. inadequate collateral flow
  2. Active infection or ischemia
  3. Surgical shunt, such as for renal dialysis
  4. Anticoagulation & Coagulopathy

B.
Complications

  1. Thrombosis
  2. Hematoma
  3. Risk of infection at the site of puncture

C.

  1. Cannula displacement into tissues
  2. Improper zero or transducer calibration
  3. Loss of counterpressure from the bag
  4. Bubbles in the catheter or system
  5. Incorrect stopcock position