Initial experience with a respiratory therapist arterial line placement service.
BACKGROUND
Indwelling arterial lines are commonly used in critical care. To standardize and improve the placement of these devices, we developed and implemented a respiratory therapist-based line placement service. As a measure of the quality of the service, we assessed the success and complications encountered in the first 119 line placement attempts of this new service.


METHODS
The following were recorded for each artery on which cannulation was attempted: the number of the attempt on which cannulation was successful; if a different person was able to cannulate the artery after initial failure; and whether any complications occurred. Success rate compared to the number of attempts was tested with chi-square.


RESULTS
Respiratory therapists were successful in placing 80% of attempted lines on the first try, including all 18 of 18 dorsal pedis attempts. Ninety-seven percent (115 of 119) of attempted arteries were ultimately cannulated. Success on second attempts by the same person was less than if a different, more experienced, person attempted the placement (p = 0.024). No complications were identified during the study.


CONCLUSIONS
Initiation of a respiratory therapist-based arterial line placement service resulted in an acceptable cannulation success rate, without complications. Increased experience of the person attempting cannulation correlates with improved success.
Rowley
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DD
Surgical Services, University of Virginia Health System, Charlottesville, USA. ddr8a@hscmail.mcc.virginia.edu
Mayo
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DF
Durbin
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CG
D001158:Arteries; D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000379:methods*; D002408:Catheters, Indwelling; D016638:Critical Illness; D005528:Foot / Q000098:blood supply; D006801:Humans; D010818:Practice Patterns, Physicians'; D011785:Quality Assurance, Health Care; D012124:Respiratory Care Units; D012138:Respiratory Therapy / Q000379:methods*