運用超音波置入周邊動脈導管—專科護理師新技能

New Skill of Nurse Practitioners: Ultrasound-guided Peripheral Arterial Catheterization

本文主要介紹專科護理師運用超音波導引置入動脈導管可減少置入時間，同時增加成功率及避免併發症。動脈導管血壓測量比非侵入性測量血壓更為準確，經常用於危急病人的照護，以取得連續血壓監測數據和頻繁的動脈血液氣體分析。常見的置入技術有留置針置入術、導引線置入術、超音波導引周邊動脈導管置入術。以超音波圖像顯示周邊動脈相對解剖位置，提升置入成功率並避免併發症，屬專科護理師在醫師監督下可合法執行之技術，建議專科護理師可接受臨床醫學標準化的超音波訓練，廣泛運用超音波導引於周邊動脈導管置入，這是歷史新局面，也是專科護理師運用儀器的新思維。

 

The main purpose of this article is to review the use of ultrasound-guided arterial catheterization by nurse practitioners to shorten the catheter insertion time, increase the success rate, and avoid related complications. Intra-arterial blood pressure measurement is more accurate than noninvasive blood pressure measurement. An arterial line is often used on critical patients for continuous blood pressure monitoring and frequent arterial blood sampling. Three common ways of inserting a peripheral arterial catheter are to catheter over the needle, over the wire, and by the guidance of ultrasound. Compared to other ways of arterial catheterization, ultrasound-guided catheterization has a better success rate and less complications by displaying images of relative anatomic position of peripheral arteries during insertion. This procedure can be legally done by nurse practitioners. Therefore, it is advisable for nurse practitioners to receive proper and standardized ultrasound training, and to perform the ultrasound guided peripheral arterial catheterization procedure extensively in their practice. This will be a new standard for applying technology by nurse practitioners and a new breakthrough in critical care.