Radial arterial line: trace the pulsation

Question 1How does ultrasound guidance change radial artery catheterisation, according to a 2014 meta-analysis of randomised trials?

1. aIt removes the need for local anaesthetic
2. bIt improves first-attempt success and reduces the number of attempts
3. cIt has no effect on attempts
4. dIt worsens first-attempt success

Question 2How do you choose the segment of radial artery to puncture?

1. aChoose the point where you feel the strongest pulse
2. bScan a few centimetres and choose a straight, superficial stretch with a clear lumen
3. cChoose the wrist crease every time
4. dChoose the bifurcation, as the artery is largest there

Question 3Why enter at a low angle?

1. aIt makes the artery larger
2. bIt avoids the need for a wrist roll
3. cIt prevents flashback
4. dIt gives better control of the needle tip and easier catheter entry

Question 4What do you do if the puncture succeeds but the catheter will not advance?

1. aRotate to long axis and look at the tip and the wall
2. bApply pressure and give up
3. cPush the catheter harder
4. dRemove the roll and extend the wrist fully