Principles of USG arterial line insertion
1. Consider using a longer cannula (2 inches or longer), especially for deep arteries.
2. Always use saline for contact between skin and probe. The slipperiness of gel impairs handling of the cannula, and dressing application.
3. Ensure basic principles of arterial line insertion are still observed, namely: (a) appropriately shallow trajectory to avoid penetrating the back wall, (b) stretching the skin to fix the vessel.
4. I recommend always starting with a short-axis view of the vessel and an out-of-plane needle approach to ensure that you are entering absolutely in-line with the vessel. After that, if preferred, you can turn the probe into a long-axis view of the vessel and the cannula to assess the trajectory.
