arterial line circle of willis CPR emergency department butthurt audacity code shift change prior authorization otherwise stable

Clutch: Resident Places A-Line Into Circle of Willis

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ATLANTA, GA – In the same way patients can be progressively difficult sticks from the venous standpoint, the same holds true for their arteries. Thankfully one determined ICU resident didn’t let this stop her as she was able to emergently and successfully place an arterial line into the circle of Willis.

“Only one word can describe this performance and that’s clutch,” said pulmonary critical care attending Dr. Max Mathiason, praising third-year medicine resident Gina Richter. He points towards the patient’s monitor. “Excellent waves forms, we’ve been able to get crucial ABGs and routine labs to help with management. Again, clutch.”

The patient was brought in by EMS after being found down, and initial work was concerning for septic shock. In the emergency room, patient had a central line successfully placed. However, the radial arterial line clotted off.

“I attempted a few more arterial lines, but couldn’t get them,” Richter told Gomerblog. “The patient was cool and clammy and the blood pressure cuff reading was unreliable. We needed that A line. I knew what I had to do.” In one try, Richter successfully placed the catheter into the patient’s circle of Willis. Not bad for a first try.

The patient is currently in stable condition.

“The good thing is that an arterial line is a safe procedure, granted that’s when dealing with arteries outside the brain,” explained Mathiason. “Talk about threading the needle. But she did it. The patient has no evidence of complications: no infection, meningitis, stroke, aneurysm, intracranial hemorrhage. Even our neurosurgeons said they couldn’t have done a better job. If that’s not a compliment, I don’t know what is.”

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