36620 Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous

Name of the Procedure:

Arterial Catheterization or Cannulation for Sampling, Monitoring, or Transfusion (Separate Procedure); Percutaneous

Summary

Arterial catheterization involves inserting a thin tube (catheter) into an artery to sample blood, monitor blood pressure, or deliver medications and blood transfusions. The procedure is done through the skin using a needle and catheter.

Purpose

This procedure helps manage and monitor critical medical conditions. It allows real-time monitoring of blood pressure and oxygen levels, blood sampling for laboratory tests, and administration of medications or transfusions directly into the arterial system.

Indications

• Persistent hypotension (low blood pressure)
• Conditions requiring frequent blood sampling, such as severe infections or multi-organ failure
• Major surgeries where continuous blood pressure monitoring is essential
• Intensive care settings for critically ill patients
• Conditions requiring direct medication administration into the artery

Preparation

• Patients may be asked to fast for several hours before the procedure.
• Medication adjustments might be necessary, especially for those on blood thinners.
• Routine blood tests and assessments, including coagulation profiles and blood type, might be performed beforehand.

Procedure Description

1. The patient's skin is sterilized, and a local anesthetic is applied to numb the insertion site.
2. Using ultrasound or palpation, the arterial puncture site is located.
3. A needle is inserted into the artery, followed by the insertion of a guide wire.
4. The catheter is threaded over the guide wire and placed into the artery.
5. The guide wire is removed, and the catheter is secured in place.
6. The catheter is connected to monitoring equipment or used for blood sampling/transfusion as required.

Commonly used equipment includes sterile needles, guide wires, arterial catheters, and ultrasound devices. Local anesthesia is typically used.

Duration

The procedure usually takes about 30 minutes.

Setting

Arterial catheterization is typically performed in a hospital setting, such as an intensive care unit (ICU) or an operating room.

Personnel

The procedure is performed by a trained physician, often an anesthesiologist, critical care specialist, or cardiologist, with assistance from nurses and other healthcare staff.

Risks and Complications

• Common: Pain, bruising, infection at the insertion site
• Rare: Arterial thrombosis (clot formation), vascular spasm, hematoma, nerve damage Complications are managed with appropriate medical or surgical interventions.

Benefits

• Accurate and continuous monitoring of blood pressure and oxygen levels
• Timely diagnosis and management of critical conditions
• Decreased need for repeated needle sticks for blood sampling

Recovery

• Patients typically stay in the ICU or a monitored hospital setting for continuous observation.
• The insertion site should be kept clean and dry.
• Recovery time varies depending on the patient's overall condition, but normal activities can usually be resumed within a few days.
• Follow-up appointments may be necessary to monitor healing and catheter function.

Alternatives

• Non-invasive blood pressure monitoring
• Central venous catheterization
• Peripheral intravenous lines for medication administration Each alternative has its pros and cons, often involving less invasive methods but may provide less precise data or require more frequent interventions.

Patient Experience

• Patients might feel slight discomfort or pressure during insertion; local anesthesia helps minimize pain.
• Post-procedure, some soreness at the insertion site is common.
• Pain management strategies, such as oral pain relievers, can help maintain comfort.
• Regular observations ensure any discomfort or complications are promptly addressed.