I read with interest the letter to editor published in May 2018 issue of IJA. The authors have suggested to use intravenous (IV) cannula for arterial lines due to non-availability of dedicated arterial cannula and suggested a modification to overcome low volume of flashback chamber to improve success rate of arterial cannulation.[1]
Using IV cannulas with an injection port for arterial cannulation is an important matter of patient safety. An arterial line is often sited in patients undergoing major surgery and/or requiring intensive monitoring because of patient factors and as a consequence they may have more than one venous access. Using an IV cannula with an injection port as an arterial line can lead to inadvertent injection of medications through the injection port in the artery with serious sequelae.[2,3] Hence, it becomes imperative to use dedicated arterial cannulae. Secondly, the modification suggested by authors (using the shaft cover to improve the success rate of arterial cannulation) cannot be generalised for all currently available IV cannula brands e.g., B Braun® and thus may not be an option.
To improve the success rate of arterial cannulation particularly for trainees, one can use barrel of 2 cc syringe in the arterial cannula after removing the blocker irrespective of the cannula brand as shown in Figure 1. Taking into consideration the dangers of inadvertent intra-arterial injection of medications through the injection port, dedicated arterial cannulas should be used for arterial lines and not IV cannulas.
Figure 1.
2 cc syringe barrel and the arterial cannula
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REFERENCES
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