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arterial cannulation

If a nurse cannulates the artery and places the introducer, is this a reportable incident?  Should the nurse have report to the MD, written an incident report and document this act in the record?  I recently heard that one of my team members did this and did not report this to the attending.  Should she be called on this? Should disciplinary action be rendered? Thanks for your information.

Rhonda Ward, RN

Karen Day
Karen Day's picture
Good question, I have never

Good question, I have never contacted the MD on the very few cases I have done this myself.  I know it is covered in the risks explained to the patient.  I generally document it on the procedure note; however, I do not state that I cannulated the artery - I state what I saw and the actions I took, i.e.

bright red, pulsatile blood noted from dilator, dilator removed and pressure held......etc.   

mary ann ferrannini
 I document what happened and

 I document what happened and what my nursing actions were and the outcome. I would only notify the MD if I needed further orders or other medical intervention. If the nurse is astute and takes remedial action it is easy to rectify the situation.

Cherokee people
I would do the same that Mary

I would do the same that Mary Ann stated.

Cannulating an artery with

Cannulating an artery with the introducer is a likely possibility and not an act of negligence or below the standard of practice. I would completely document what happened in the medical record and any patient response. If further medical interventions were required, that would mean notifying the physician. Otherwise, I do not think it would be necessary. However, if the nurse had failed to recognize the arterial cannulation, and proceeded to place the PICC, there is still the opportunity to recognize this problem on the chest xray as arterial placements are in a very different location than venous placements. Arterial placements are often confused with a left persistent SVC. If there is ever any question about PICC tip location, there are still 2 ways to thoroughly rule out arterial placement - drawing blood from the catheter and running blood gases and transducing the line for pressure. If the nurse fails to properly recognize arterial placement or fails to assess for arterial placement on the xray AND then fails to obtain the tests to rule out arterial placement AND there is patient harm, then there can be a successful lawsuit. I have been the expert in a few of these cases. So there are several opportunities to make sure the catheter is not in the artery before it is used for infusion. The negligence comes when one fails to use those chances to correctly identify location. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Karen Day
Karen Day's picture
I have had a couple of

I have had a couple of patients with a persistent left SVC and these were documented by the Radiologist by way of CT for the patient.  For one patient, the interventionalist chose to administer a small amount of dye under fluoro and it was indeed a left SVC, either way as Lynn said, I had these verified and documented to ensure they were left sided SVC's.


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