Mastering Ultrasound-Guided Arterial Lines [FULL version]

Ultrasound-guided arterial line insertion is a useful adjunct to the anatomical landmark-guided technique (see here:    • How To Succeed At Arterial Line Insertion ...   ), particularly in high-stakes patients or when anatomy is challenging.
Success in these difficult scenarios is increased by attention to certain key principles and maneuvers. These are illustrated here with examples from challenging patients. Two advanced alternative strategies are also described: (1) The hybrid short-axis out-of-plane (SAX-OOP) + long-axis in-plane (LAX-IP) approach; and (2) Ulnar artery cannulation
(Note: I do not recommend starting with a LAX-IP approach because it is very difficult to achieve accurate alignment of all 3 structures: the US beam, the artery, and the cannula. Use the SAX-OOP approach to align cannula and the artery and then rotate into the LAX-IP view)

This video is for informational and educational purposes only. It is not a substitute for professional medical advice, or consultation with a health care professional.

00:12 Preparation
02:10 Scout scan
04:22 Superficial radial artery
07:01 Calcified artery
08:06 Skin insertion
11:31 Trajectory angle
12:04 Tip tracking
13:07 Cannulation
15:30 Hybrid SAX-OOP+LAX-IP
18:16 Ulnar art line
21:19 Final e.g.