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Initial experience with a respiratory therapist arterial line placement service
D D Rowley1, D F Mayo, C G Durbin
1Surgical Services, University of Virginia Health System, Charlottesville, USA. ddr8a@hscmail.mcc.virginia.edu
Background:
Indwelling arterial lines are commonly used in critical care. To standardize and improve the placement of these devices, we developed and implemented a respiratory therapist-based line placement service. As a measure of the quality of the service, we assessed the success and complications encountered in the first 119 line placement attempts of this new service.
Methods:
The following were recorded for each artery on which cannulation was attempted: the number of the attempt on which cannulation was successful; if a different person was able to cannulate the artery after initial failure; and whether any complications occurred. Success rate compared to the number of attempts was tested with chi-square.
Results:
Respiratory therapists were successful in placing 80% of attempted lines on the first try, including all 18 of 18 dorsal pedis attempts. Ninety-seven percent (115 of 119) of attempted arteries were ultimately cannulated. Success on second attempts by the same person was less than if a different, more experienced, person attempted the placement (p = 0.024). No complications were identified during the study.
Conclusions:
Initiation of a respiratory therapist-based arterial line placement service resulted in an acceptable cannulation success rate, without complications. Increased experience of the person attempting cannulation correlates with improved success.