critical care medicine
How To Do Radial Artery Cannulation, Ultrasound Guided
Additional Considerations for US Guided Radial Artery Cannulation
Arterial catheterization is done under universal (barrier) precautions and sterile conditions. The short-axis (transverse, cross-sectional) ultrasound view is easy to obtain and is the best view for identifying veins and arteries and their orientation to each other. However, the transverse view also shows the needle in cross-section (hyperechoic [white] dot), and the needle tip can be distinguished only by the appearance and disappearance of the white dot as the imaging plane traverses past the needle tip. The long-axis (longitudinal, in-plane) ultrasound view is technically more difficult to obtain (must keep probe, vein, and needle in one plane), but the entire needle (including the tip) is imaged continuously, which ensures accurate intraluminal placement. The narrowness of the radial artery increases the difficulty of obtaining the longitudinal view. 