Femoral Artery Access – Some Thoughts

One of my main goals in the first few months in the cath lab was to get access without any complications or help (although, one always could use the help). One of the tricks that I learned is where and how I felt the artery. Four fingers on the pulse, now here is what I think made it easier: After you feel the pulse move your fingers form lateral to medial direction and then back. This way you will get your fingers where the pulse is the strongest. My first few times, I would make the mistake of just feeling the pulse and going in with the needle, which at times would cause me to miss the artery as I was too medial or lateral. Now, I can get access most of the time (knock on wood) with my first attempt as I know where the pulse is the strongest.

Also, once you are advancing the needle, at times you can feel the needle pulsate in your fingers as you approach the artery. This was another little trick taught by one of my attendings, as you are advancing the needle slowly and if you are not sure where you might be, just stop for a second, hold the needle lightly and see if you can feel the pulsations of the artery in your fingers.

Good Luck. Would love to read more from others…