36120 Introduction of needle or intracatheter; retrograde brachial artery

Name of the Procedure:

Introduction of Needle or Intracatheter; Retrograde Brachial Artery

Summary

The introduction of a needle or intracatheter into the retrograde brachial artery is a medical technique used to gain access to the brachial artery in the arm. This procedure is typically used for diagnostic or therapeutic purposes, such as drawing blood samples, measuring blood pressure within the arteries, or administering medications directly into the bloodstream.

Purpose

The primary purpose of this procedure is to access the brachial artery for diagnostic tests or therapeutic interventions. It is often used to:

• Obtain accurate blood pressure measurements from within the artery.
• Draw arterial blood samples for testing gases and other critical parameters.
• Administer medications that need to be delivered directly into the arterial bloodstream.

Indications

This procedure may be indicated for:

• Patients requiring frequent arterial blood gas sampling.
• Critical care patients needing continuous blood pressure monitoring.
• Situations where rapid medication delivery is necessary, such as in some emergencies or surgeries.

Preparation

Patients may be instructed to:

• Avoid eating or drinking for a certain period before the procedure (typically 6-8 hours if general anesthesia is used).
• Inform the healthcare provider of any medications they are taking, including over-the-counter drugs and supplements.
• Undergo pre-procedure diagnostic tests, such as blood tests or imaging studies, to assess the artery and surrounding structures.

Procedure Description

1. The patient is positioned comfortably, usually with their arm extended.
2. The insertion site on the arm is cleaned and sterilized.
3. Local anesthesia may be applied to numb the area.
4. Using ultrasound guidance, the physician carefully inserts a needle or intracatheter into the brachial artery.
5. Once the artery is accessed, the needle may be replaced with a catheter.
6. The catheter can be used to draw blood samples, measure blood pressure, or deliver medications as needed.
7. Upon completion, the catheter is removed, and pressure is applied to the site to prevent bleeding.

Duration

The procedure typically takes about 30 minutes to 1 hour to complete.

Setting

This procedure is usually performed in a hospital, outpatient clinic, or surgical center.

Personnel

The procedure involves:

• A physician or interventional radiologist who performs the insertion.
• Nurses or medical assistants who prepare the patient and assist throughout the procedure.
• An anesthesiologist or nurse anesthetist if sedation or general anesthesia is required.

Risks and Complications

Common risks include:

• Bleeding or bruising at the insertion site.
• Infection.
• Arterial spasm.
• Hematoma.

Rare risks may include:

• Vascular injury.
• Nerve damage.
• Embolism.

Benefits

The expected benefits include:

• Accurate and timely diagnostic information.
• Effective administration of medications.
• Improved patient outcomes in critical care settings. Benefits are usually realized immediately upon successful completion of the procedure.

Recovery

Post-procedure care includes:

• Monitoring the insertion site for signs of infection or complications.
• Keeping the insertion site clean and dry.
• Avoiding heavy lifting or strenuous activities for a specified period.
• Follow-up appointments as recommended by the physician.

Alternatives

Alternatives to this procedure may include:

• Non-invasive blood pressure measurements.
• Venous blood sampling for less critical assessments.
• Administration of medications through peripheral vein access. Alternatives may be less invasive but might not provide the same level of accuracy or immediate effect.

Patient Experience

During the procedure, the patient may feel:

• Mild discomfort or pressure at the insertion site.
• Some pain or burning if local anesthesia is used. After the procedure, the patient may experience:
• Mild soreness or bruising at the insertion site. Pain management measures include applying ice packs, taking over-the-counter pain relievers, and following the healthcare provider's post-procedure instructions for care and comfort.