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Chapter: Essential Anesthesia From Science to Practice : Clinical management : Vascular access and fluid management

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Confirmation of intravenous location - Vascular access

Several techniques can help to confirm that the needle is not in an artery – usually the carotid. While pulsatility and a bright red color are good hints, they are not foolproof.

Confirmation of intravenous location

Several techniques can help to confirm that the needle is not in an artery – usually the carotid. While pulsatility and a bright red color are good hints, they are not foolproof.

·           If ultrasound guidance was used to place the catheter (as is routine at our insti-tution), use it to confirm position as well.

·           Attach a length of sterile clear tubing to the needle hub and lower the end, allowing it to fill several centimeters with blood, then raise above the patient’s heart level. A rising column of pulsating blood confirms arterial location, while a column that reflects the central venous pressure is a more welcome finding.


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