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Setting Up Arterial Transducer Steps

Aug 7, 2024

Lecture Notes: Setting Up an Arterial Transducer

Lecturer: Sallow Bhandari, NYU Medical Center/Bellevue Hospital

Introduction

  • Purpose: Demonstrating how to set up an arterial transducer
  • Common practice: Nurses typically handle this
  • Goal: Teach healthcare professionals to do it themselves
  • Partner: Dr. Brian Lynn

Required Equipment

  • Pressure cable
  • Transducer holder
  • Pressure bag
  • 500cc bag of normal saline
  • Tubing and transducer kit

Overview of the System

  • Fluid path: Normal saline bag → Tubing → Transducer → Syringe (auxiliary port) → Patient
  • Function: Pressure wave from artery moves fluid column, detected by transducer, converts to an electrical signal, displayed on monitor as arterial blood pressure

Setup Steps

Step 1: Hooking Up the Pressure Bag

  1. Spike the 500cc normal saline bag
  2. Place saline bag in the pressure bag
  3. Pump the pressure bag to 300 mmHg
  4. Turn stopcock to maintain pressure
  5. Attach pressure bag to IV pole

Step 2: Attaching Equipment to the IV Pole

  1. Place transducer holder on IV pole
  2. Attach setup to transducer holder
    • Syringe in middle section (numbers facing up)
    • Transducer in slot (cord facing downwards)
  3. Ensure clear path: Pressure bag → Transducer → Syringe → Patient

Step 3: Removing Air from IV Lines

  1. Remove air from pressure bag to transducer
    • Use stopcock to direct fluid flow
    • Pull tab to allow fluid to escape, remove bubbles
  2. Remove air from transducer to patient tubing
    • Use basin to catch fluid

Step 4: Connecting to Monitor

  1. Connect transducer to monitor port (left port recommended at NYU)
  2. Check for artifact on monitor by moving patient end tubing

Step 5: Zeroing the Arterial Line

  1. Expose port with hole to atmosphere
  2. Use stopcock to direct flow
  3. Unscrew cap, expose to atmosphere
  4. Press zero button on monitor (Zero ABP)
  5. Replace cap with one that has no hole

Additional Procedures

Drawing Blood

  1. Use syringe to draw blood from arterial line
  2. Withdraw necessary amount of blood and then return waste blood to patient

Troubleshooting

  • Overdamped Wave (flattened waves):
    • Check pressure bag inflation
    • Ensure proper leveling
    • Remove air bubbles and kinks
  • Underdamped Wave (large waves):
    • Remove air bubbles
    • Reduce excess tubing

Correct Placement

  • Leveling at patient's phlebostatic axis: Intersection of 4th intercostal space and mid-axillary line

Conclusion

  • Steps summarized: Pressure bag setup, air removal, zeroing
  • Encouragement to practice
  • End of video

Full transcript