{"id":3129,"date":"2026-03-20T13:28:19","date_gmt":"2026-03-20T21:28:19","guid":{"rendered":"https:\/\/www.nicolekupchikconsulting.com\/news\/?p=3129"},"modified":"2026-03-20T13:28:21","modified_gmt":"2026-03-20T21:28:21","slug":"can-you-trust-your-arterial-line","status":"publish","type":"post","link":"https:\/\/www.nicolekupchikconsulting.com\/news\/can-you-trust-your-arterial-line\/","title":{"rendered":"Can You Trust Your Arterial Line?"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">When caring for your critically ill patient, this question often arises.&nbsp; You should definitely know the answer to this question.&nbsp; But, how do you know?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">An ICU patient will often have an arterial line placed for continuous invasive blood pressure monitoring, especially if they are receiving vasoactive infusions, unstable &amp; being resuscitated.&nbsp; It is your job as the nurse to make sure this line is set-up correctly, so you can treat your patient appropriately.&nbsp; You are actively making moment by moment decisions to titrate pressors or vasoactive drips up or down, give fluid, blood, you name it based on these numbers.&nbsp; So, it is imperative that you know if you can trust your arterial line.<\/p>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"624\" height=\"224\" src=\"https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/Picture1.png\" alt=\"\" class=\"wp-image-3130\" srcset=\"https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/Picture1.png 624w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/Picture1-300x108.png 300w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/Picture1-370x133.png 370w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/Picture1-270x97.png 270w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/Picture1-570x205.png 570w\" sizes=\"auto, (max-width: 624px) 100vw, 624px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Make sure your arterial line is set up appropriately:<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Must be transduced &amp; pressurized with 300 mm Hg pressure<\/li>\n\n\n\n<li>Patient should be supine with HOB 0 &#8211; 60 degrees<\/li>\n\n\n\n<li>Zeroed &amp; leveled to phlebostatic axis (4th intercostal space mid AP &#8211; <em>see image below<\/em>)<\/li>\n\n\n\n<li>Re-level with every position change<\/li>\n\n\n\n<li>Zero pre-insertion, post-insertion, disconnecting, reconnecting, or if your numbers are not matching the clinical picture<\/li>\n\n\n\n<li>Make sure your saline bag has enough volume<\/li>\n\n\n\n<li>Make sure your connections are tight &amp; remove as much excess tubing as possible<\/li>\n\n\n\n<li>When priming your tubing, prime with gravity, this reduces air bubbles that can lead to overdamped or underdamped lines<\/li>\n<\/ul>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" src=\"https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_SideAnatomy-1024x1024.png\" alt=\"\" class=\"wp-image-3132\" style=\"width:345px;height:auto\" srcset=\"https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_SideAnatomy-1024x1024.png 1024w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_SideAnatomy-300x300.png 300w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_SideAnatomy-150x150.png 150w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_SideAnatomy-768x768.png 768w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_SideAnatomy-370x370.png 370w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_SideAnatomy-270x270.png 270w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_SideAnatomy-570x570.png 570w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_SideAnatomy-740x740.png 740w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_SideAnatomy.png 1500w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" src=\"https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_RadialArterySite-1024x1024.png\" alt=\"\" class=\"wp-image-3133\" style=\"width:329px;height:auto\" srcset=\"https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_RadialArterySite-1024x1024.png 1024w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_RadialArterySite-300x300.png 300w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_RadialArterySite-150x150.png 150w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_RadialArterySite-768x768.png 768w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_RadialArterySite-370x370.png 370w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_RadialArterySite-270x270.png 270w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_RadialArterySite-570x570.png 570w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_RadialArterySite-740x740.png 740w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_RadialArterySite.png 1500w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n<\/div>\n\n\n<h2 class=\"wp-block-heading\">Perform the Dynamic Response Test AKA the \u201cFast Flush Test\u201d or the \u201cSquare Wave Test\u201d<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>It helps you decide if you can trust the number<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>What to look for:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Perform a 1 second flush<\/li>\n\n\n\n<li>Assess the square wave form on the monitor<\/li>\n\n\n\n<li>Count the number of oscillations after the square wave, before it returns to baseline (should see 1 &#8211; 2 oscillations in 0.12 seconds)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>When to perform:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Every shift<\/li>\n\n\n\n<li>When the system is open to air<\/li>\n\n\n\n<li>When the waveform changes<\/li>\n<\/ul>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" src=\"https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_PWDamping-1024x1024.png\" alt=\"\" class=\"wp-image-3134\" style=\"width:488px;height:auto\" srcset=\"https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_PWDamping-1024x1024.png 1024w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_PWDamping-300x300.png 300w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_PWDamping-150x150.png 150w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_PWDamping-768x768.png 768w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_PWDamping-370x370.png 370w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_PWDamping-270x270.png 270w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_PWDamping-570x570.png 570w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_PWDamping-740x740.png 740w, https:\/\/www.nicolekupchikconsulting.com\/news\/wp-content\/uploads\/2026\/03\/NKC_Illustrations_PWDamping.png 1500w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\">One pro-tip is that if your arterial line is zeroed &amp; leveled, but overdamped or underdamped, you can always trust the MAP.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Also, don\u2019t be afraid to tell your provider that your arterial line is failing.&nbsp; They don\u2019t last forever, so sometimes you either need a new one or it\u2019s just time to take it out.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If you can embed one thing into your critical care practice, it is to make sure you can answer assuredly whether or not you can trust your arterial line!<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Even when focusing on arterial lines, I always find it worthwhile to revisit hemodynamics, resources like Nicole Kupchik\u2019s <strong><a href=\"https:\/\/www.nicolekupchikconsulting.com\/booksAndCourses\/online-courses\/17\/hemodynamic-monitoring-boot-camp\">Hemodynamic Monitoring Bootcamp Online Course<\/a><\/strong> are a great reminder that there\u2019s always something new to learn each time you dive back in.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">References:<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www-uptodate-com.offcampus.lib.washington.edu\/contents\/intra-arterial-catheterization-for-invasive-monitoring-indications-insertion-techniques-and-interpretation?search=arterial%20line&amp;source=search_result&amp;selectedTitle=1~150&amp;usage_type=default&amp;display_rank=1\">Intra-arterial catheterization for invasive monitoring: Indications, insertion techniques, and interpretation &#8211; UpToDate<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.aacn.org\/docs\/Photos\/Procedure-59-4ihnnti3.pdf\">AACN Arterial Line Procedure<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/aacnjournals.org\/ccnonline\/article\/36\/4\/e12\/3641\/Pulmonary-Artery-Central-Venous-Pressure\">Pulmonary Artery\/Central Venous Pressure Monitoring in Adults | Critical Care Nurse |<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/aacnjournals.org\/ccnonline\/article\/36\/4\/e12\/3641\/Pulmonary-Artery-Central-Venous-Pressure\">American Association of Critical-Care Nurses<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>When caring for your critically ill patient, this question often arises.&nbsp; You should definitely know the answer to this question.&nbsp; But, how do you know? An ICU patient will often have an arterial line placed for continuous invasive blood pressure monitoring, especially if they are receiving vasoactive infusions, unstable &amp; being resuscitated.&nbsp; It is your [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":3136,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[44,46],"tags":[67,66,57],"ppma_author":[62],"class_list":["post-3129","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-hemodynamics","category-nurse-education","tag-arterialline","tag-hemodyanmics","tag-nicolekupchik"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\r\n<title>Can You Trust Your Arterial Line? - Nicole Kupchik Blog<\/title>\r\n<meta name=\"description\" content=\"Learn how to determine if you can trust your arterial line ensure accurate hemodynamic monitoring in critically ill patients.\" \/>\r\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\r\n<link rel=\"canonical\" href=\"https:\/\/www.nicolekupchikconsulting.com\/news\/can-you-trust-your-arterial-line\/\" \/>\r\n<meta property=\"og:locale\" content=\"en_US\" \/>\r\n<meta property=\"og:type\" content=\"article\" \/>\r\n<meta property=\"og:title\" content=\"Can You Trust Your Arterial Line? 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