ABSTRACT
If inadvertent arterial puncture occurs with a finder needle or angiocath, the needle or catheter should be withdrawn as soon as this is recognized and pressure applied to compressible vessel. Direct pressure will be required for longer periods in those patients who do have a coagulopathy. In those patients with coagulopathy in whom this complication is recognized with the catheter already in place, it is probably prudent to correct the coagulopathy before withdrawal of the catheter. Every effort should be made to confirm intravenous and exclude intraarterial placement before using a vessel dilator. If there is any doubt, the pressure in the vessel can be transduced or estimated by the height of blood in attached tubing, or a sample sent for blood gas analysis. Visual inspection of blood pulsatility and color can be unreliable in patients who are hypoxic, in shock, or compromised by tricuspid regurgitation and volume overload.
