Arterial Line Time

Brenda gently yet realistically prepared me for the arterial line placement – it would be uncomfortable, and there would be a good chance that they wouldn’t be able to place it on the first try. They would try up to three times on each arm – with my permission, of course. The insertion area would be numbed with a local anesthetic to minimize pain during insertion; the arterial catheter itself would be about two inches long.

Arterial catheter. Photo courtesy Medscape.
Arterial catheter. Photo courtesy Medscape.

Once the line was successfully placed, my arm would be strapped to a splint to keep me from moving it. The anesthetic would wear off within an hour; she warned me that it would be sore. The longer the line would be in place, the more discomfort and soreness – and my line was to be in for a solid five hours, so I could expect some discomfort.

The arterial line was for taking blood samples and also to monitor my blood pressure. Blood samples would be taken throughout the procedure – more frequently at the beginning and less frequently towards the end – fourteen samples would be taken in all. In addition to the arterial line in my left arm, an intravenous line would be placed in my right arm; this line would be used for infusion of the radiotracer.

Soon it was time for the placement of my arterial line. Brenda showed me to my room where I met the cardiologist, a woman whose name unfortunately escapes me. Again – friendly, personable, chatty…and honest. She was from India, and had a pleasant way of speaking that made everything she said sound like good news. Yet another winner.

Insertion. Photo courtesy Medscape.
Insertion. Photo courtesy Medscape.

She expressed her concern over my age and gender with regards to the line placement – apparently the arteries in young women tend to spasm more often, resulting in difficulty placing and keeping the catheter in. She tells me this as I am in the bed with my arm stretched across the table and being prepped. I spot the needle – the arterial catheter.

Two inches looked way longer than I remember it being…holy cow.

I’m a little nervous – but not too much. For some reason I have always been able to tune out pain pretty effectively…almost shutting it off. I figured if I was able to give birth to two children without pain medication, I could handle this. The cardiologist is on my left side, prepping my wrist, Brenda is on my right side holding my hand and gently tapping my forearm – she said it was something that many patients had told her was soothing, and it was. I’m comfortable, covered in one of those heavenly warmed blankets – and I am ready.

The doctor swabs my wrist with Betadine solution, then begins to inject the local anesthetic – she and Brenda are talking, the kind of conversing in which it was easy to both participate or not. I close my eyes and tell my arteries – everything is fine. Don’t be spastic – we’re cool, just chill. After this silly little conversation with my arteries I focused on my breathing, and soon I felt a pressure in my wrist, along with a deep aching and burning. I keep breathing, and shut off the pain.

After a few moments I feel hot liquid spilling over my wrist and hand – and I knew she had nailed it. I was a little surprised at how much blood there was…and the force that was behind it. I chose not to look, but if I ever have it done again, I think I just might.

The cardiologist sounded surprised when she said “Oh, look at that! You got lucky!” One and done – it was in.

My arm was strapped to a padded board, and stayed that way for the next five and a half hours, which was awkward and uncomfortable. After everything was secured, cleaned and I was settled in again, Brenda brought me lunch – a turkey sandwich, fresh orange, and an apple juice – then disappeared for a while to prep another subject. The sandwich was easy enough…but I wondered how in the hell I was supposed to peel an orange with one hand. I tossed it in my bag for the trip home.

The arterial line insertion was successful after only one try!
The arterial line insertion was successful after only one try!

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