Arterial Lines

Quick Overview

An arterial line (“art line”) is a thin catheter placed in an artery that allows continuous blood pressure monitoring and easy access for arterial blood sampling. This page gives a quick nursing overview of what an arterial line is, why it is used, how to assess it, and key safety steps to prevent complications such as bleeding, infection, and limb ischemia.

What Is an Arterial Line?

An arterial line is a small catheter placed directly into an artery, most commonly the radial artery, but sometimes the femoral, brachial, or dorsal pedis.

It connects to a pressurized tubing system and transducer that displays a continuous arterial waveform and blood pressure on the monitor.
Unlike central lines and PICCs, arterial lines are not used for routine fluid or medication infusions (unless ordered in very specific situations).

Why Do We Use Arterial Lines?

Arterial lines are used when patients need closer hemodynamic monitoring, such as:

Continuous, real-time blood pressure monitoring in unstable or critically ill patients
Frequent arterial blood gases (ABGs) without repeated needle sticks
Better beat-to-beat monitoring during surgery, shock, or titration of vasoactive medications

Arterial Line – Nursing Assessment Checklist

Each shift and regularly during your care, assess:

Insertion site & dressing: redness, swelling, warmth, tenderness, drainage, bleeding; dressing clean, dry, intact
Limb circulation: color, temperature, capillary refill, pulse (if palpable) distal to the site; compare to the other limb
Line & connections: tubing intact, no kinks, secure connections, stopcocks and caps closed appropriately, pressure bag inflated (usually to 300 mmHg)
Waveform & readings: appropriate arterial waveform, values that make sense compared with cuff BP, alarms set correctly
Patient: pain, numbness, tingling, coolness, or weakness in the limb with the art line

Troubleshooting

Troubleshooting (Quick Nurse Actions)

Damp dressing or bleeding: Apply pressure as needed, reinforce/replace dressing per policy, verify securement, and notify provider if bleeding continues.

Flat or dampened waveform / inaccurate BP: Check patient position, tubing/kinks, connections, pressure bag inflation, and re-zero/level per policy.

Cool/pale/numb extremity: Stop and assess circulation immediately, compare to other limb, and notify provider urgently (possible impaired perfusion).

Line pulled or disconnected: Clamp if appropriate per equipment, control bleeding, maintain sterility, and escalate right away.

Section: Knowledge Check

1) The most important assessment after receiving a patient with a new arterial line is:

A) Bowel sounds

B) Neurovascular/perfusion checks distal to the site

C) Appetite level

D) Skin turgor only

2) A suddenly damp dressing with active bleeding at the arterial line site should be treated by:

A) Leaving it and rechecking later

B) Applying pressure, securing the line, and escalating if bleeding persists

C) Turning off alarms

D) Removing the dressing and leaving it open to air

3) Which finding is most concerning?

A) Warm fingers and brisk cap refill

B) Cool, pale hand with delayed cap refill on the arterial line side

C) Patient is sleepy after pain meds

D) Dressing is clean and dry

4) When an arterial line BP seems inaccurate, the nurse should first:

A) Document it as “machine error” and move on

B) Check tubing/kinks/connections and re-zero/level per policy

C) Silence alarms permanently

D) Remove the line immediately

5) The arterial line is most commonly used for:

A) Long-term antibiotics at home

B) Continuous blood pressure monitoring and frequent ABGs

C) Total parenteral nutrition only

D) Dialysis

Arterial Line – Reflection Questions

Art Line R1: What is one thing you will check more carefully the next time you care for a patient with an arterial line?

Art Line R2: After reading this section, what signs of limb ischemia will you pay attention to that you might have overlooked before?

Art Line R3: How comfortable are you with interpreting an arterial line waveform and readings (1–5), and what would help you feel more confident?

Patient Handouts

Arterial Line Placement – Health Library (patient sheet)

https://healthlibrary.ecuhealth.org/Library/HealthSheets/3%2CS%2C41003?utm_

Arterial Catheter Patient Info

https://uthsc.edu/pulmonary/clinical-care/documents/arterial-cath.pdf?utm_

References:

Vahedian-Azimi, A., Rahimi-Bashar, F., Pourhoseingholi, M.-A., Salesi, M., Shamsizadeh, M., Jamialahmadi, T., Gohari-Moghadam, K., & Sahebkar, A. (2021). Effect of the Specific Training Course for Competency in Doing Arterial Blood Gas Sampling in the Intensive Care Unit: Developing a Standardized Learning Curve according to the Procedure’s Time and Socioprofessional Predictors. BioMed Research International, 1–10.

Oi, M., Maruhashi, T., Kurihara, Y., & Asari, Y. (2023). Evaluation of a new insertion site for arterial pressure line in intensive care unit management: a prospective study. Journal of Clinical Monitoring & Computing, 37(3), 867–872.

Reynolds, H., Gowardman, J., & Woods, C. (2024). Care bundles and peripheral arterial catheters. British Journal of Nursing, 33(2), S34–S41.

Girgenti, C., Pieroni, S., & Smith, T. (2025). A vascular access team’s journey to central venous catheter and arterial catheter insertion. British Journal of Nursing, 34(7), S14–S19.

One of the images used on this site, adapted from Vascular Wellness. (n.d.). Arterial lines. https://www.vascularwellness.com/arterial-lines/