Arterial Lines

One of the fun things about ICU is that it is a procedures service. We maintain airways, monitors, and access for patients. One of the more common and less risky procedures is the arterial line. By cannulating the radial (or dorsalis pedis) artery, we can transduce the blood pressure and draw arterial blood gases. It's similar to but more difficult than placing an IV. Over the last week and a half, I've placed a few arterial lines (and attempted several more), and I've realized I like procedures. I like being hands-on, planning, troubleshooting, and the instant gratification once something works.

I've also seen a few emergency intubations when a patient's respiratory status acutely decompensates. It's really good watching the anesthesia residents approach the potentially scary airway and how they keep their methodical train of thought even in stressful situations. The other more difficult procedure is the central line, a catheter placed into the internal jugular or subclavian vein; I've seen the residents place a few for patients who needed better cardiac monitoring or medications that cannot be given through a peripheral IV.