Ｍiller麻醉学关于桡动脉穿刺的操作（英文版）.docVIP

Ｍiller麻醉学关于桡动脉穿刺的操作：Percutaneous radial artery cannulation. (A) The wrist is positioned and the artery identified by palpation. (The catheter-over-needle assembly is introduced through the skin and advanced toward the artery. (C) Entry of the needle tip into the artery is identified by the flash of arterial blood in the needle hub reservoir. (D) Needle-catheter assembly is advanced at a lower angle to assure entry of the catheter tip into the vessel. (E) If blood flow continues into the needle reservoir, the catheter is advanced gently over the needle into the artery. (F) The catheter is attached to pressure monitoring tubing while maintaining proximal occlusive pressure on the artery. See text for greater detail.  Salvaging arterial cannulation. (A) When blood flow into the needle reservoir ceases, the needle tip has exited the vessel lumen. (The needle tip is withdrawn several millimeters so that the catheter tip becomes the leading edge of the needle-catheter assembly and arterial blood flow reappears in the collection reservoir. (C) When arterial blood flow is reestablished, the catheter is advanced into the arterial lumen.  Salvaging arterial cannulation (II). (A) When blood flow into the needle reservoir ceases, both the needle tip and catheter tip may have exited the vessel lumen. (The needle tip is withdrawn several millimeters so that the catheter tip becomes the leading edge of the needle-catheter assembly. (C) If arterial blood flow does not reappear in the collection reservoir, the entire needle catheter assembly is now withdrawn, allowing the catheter tip to reenter the vessel as the leading edge. This is confirmed by the reappearance of arterial blood flow in the collection reservoir. (D) When arterial blood flow has been reestablished, the catheter is advanced into the arterial lumen.  Using a guide wire to aid arterial cannulation. (A) A catheter may not thread into a tortuous artery. (The needle is removed from the catheter, and a guide wire is