Ultrasound-Guided Radial Artery Puncture by Nurses in Emergency Department: A Randomized Controlled Study

J Emerg Nurs. 2024 May;50(3):373-380. doi: 10.1016/j.jen.2024.01.001. Epub 2024 Mar 26.

Abstract

Introduction: Radial artery puncture has been performed by palpation as a standard method in many emergency departments and intensive care units. Nurses play an important role in the care of patients in various settings. Ultrasonography can be performed and interpreted not only by physicians but also by nurses. This study aimed to evaluate whether emergency nurses would be more successful in radial artery puncture procedure by using ultrasonography instead of palpation.

Methods: This single-center, prospective, randomized controlled study was conducted in the emergency department. The patients included in the study were randomized into 2 groups as ultrasonography and palpation groups. Data were recorded on the number of interventions, the duration of the procedure in seconds, total time in seconds, whether the puncture was successfully placed, whether there were complications, the types of complications (hematoma, bleeding, and infection), or whether it was necessary to switch to an alternative technique.

Results: A total of 72 patients, 36 patients in the ultrasonography group and 36 patients in the palpation group, participated in the study. The success rate at the first attempt was statistically significantly higher in the ultrasonography group. Although hematoma formation among the complications occurred in the entire palpation group, it was observed in 72.2% of the ultrasonography group. Puncture time and total time were statistically significantly lower in the ultrasonography group.

Discussion: Our study shows that emergency nurses can use bedside ultrasonography for radial artery puncture successfully.

Keywords: Arterial blood gas; Emergency; Emergency nurse; Intervention; Point-of-care ultrasound; Radial artery puncture.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Catheterization, Peripheral / methods
  • Catheterization, Peripheral / nursing
  • Emergency Nursing* / methods
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Palpation / methods
  • Palpation / nursing
  • Prospective Studies
  • Punctures / methods
  • Radial Artery* / diagnostic imaging
  • Ultrasonography, Interventional* / methods