Arterial Cannula Insertion 

Equipment: 

Personal protective equipment 
500 mL pressure infuser cuff 
Pressure monitoring system equipment 
Designated arterial cannula 
Sterile intravenous pack 
Sterile Gloves 
Transparent dressing 
10 mL syringe 
5 mL syringe 
2% chlorhexidine in alcohol swab 
Arterial line Labels 
Dressing Trolley 
Normal Saline 500mls 
1% lidocaine (10mls) 
Blue needle 
Orange needle 
 
Below is the usual process for illustrative purposes only; Note – this procedure must be undertaken by a skilled and competent healthcare professional 
 
Pre‐procedure 
1. Introduce yourself to the patient, explain and discuss the procedure with them, and gain their consent. 
2. Wash hands with soap and water, or an alcohol‐based handrub, and dry. 
3. Prepare the infusion and flush the transducer set using aseptic technique ensuring no air bubbles or kinks in the line. 
4.Check that all connections are secure. 
 
Procedure 
1. Wash hands with soap and water, or an alcohol‐based handrub, and dry. 
2. Prepare a trolley near the patient. 
3. Complete the Allen test if the radial artery is to be used (to ensure collateral (ulnar) pulse present. 
4. Prepare the insertion site with a 2% chlorhexidine in 70% alcohol swab and place a sterile towel under the area. 
5. Administer adequate local anaesthetic. 
6. The nurse may act as an assistant and hold the patient’s foot or arm. If the radial artery is cannulated, the wrist must be hyperextended. Don’t forget to return the wrist to the neutral position following cannulation. 
7. Insert the cannula and observe for blood flashback. 
8. Attach the transducer set (first confirming it is flushed adequately) and open the roller clamp. 
9. Apply a transparent dressing over the cannula and tape the tubing securely. 
10. Clearly label the device as arterial, on the dressing as well as on the tubing, adding the date of insertion. 
11. Secure the line to the patient further up the line (If the line is arterial this is often done by looping the set loosely around the thumb)  
12.Connect the transducer to the monitoring equipment. 
13. Zero the arterial line in line with the phlebostatic axis (4^th intercostal space mid axillary line): 
 
(the transducer will read an arterial pressure calibrated to atmospheric air, which offsets the extraneous atmospheric and hydrostatic pressures). 

Post‐procedure 
1. Clearly document the date of insertion and the placement of the arterial cannula in the patient’s records. 
2. Set appropriate alarm limits on the monitor. 
3. Continue to monitor site and limb at minimum hourly – checking for colour, warmth, and when possible – sensation and movement. 
4. Dispose of clinical waste and sharps in the sharps bin according to local policy