Arterial access in the pediatric emergency department.
Arterial catheters are used frequently to monitor critically ill children in ICUs, but their role in the emergency department has not been described. The medical records of all patients admitted to the ICU from the ED of a children's hospital during a 30-month period were reviewed retrospectively. Forty-one patients were identified as having arterial catheters placed in the ED. Catheterization was performed for serial blood gas determinations (59%) or continuous blood pressure monitoring (41%). The radial artery was catheterized in 73% of the 41 patients, and a 22-gauge catheter was used in 78% of the patients. The original catheter was discontinued before the end of medical indication in only 24% of cases--17% were discontinued for failure to draw and 7% for vascular changes at the site of the catheter. We conclude that arterial access can be used for children in the ED to monitor blood pressure and that blood gas tensions and complications are few and generally minor.
Saladino
R
R
Division of Emergency Medicine, Children's Hospital, Boston, Massachusetts 02115.
Bachman
D
D
Fleisher
G
G
D000293:Adolescent; D001900:Boston; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000706:statistics & numerical data*; D002408:Catheters, Indwelling / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004630:Emergencies; D004636:Emergency Service, Hospital; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008991:Monitoring, Physiologic / Q000009:adverse effects / Q000706:statistics & numerical data; D012189:Retrospective Studies