Q: You decided to put arterial line in dorsalis pedis artery. You get reminded by nursing student at bedside that all arterial lines should be placed after checking collateral blood flow like performing Allen test for radial artery placement. How you can perform collateral blood flow check before dorsalis artery catheter insertion?



Answer:

Occuld the dorsalis pedis artery and compress the nail bed of the great toe - relieve pressure after few seconds -. In intact collateral blood flow, color at nail bed should restore within 2-3 seconds (capillary refill). It would be of help to simultaneously perform Buerger’s Test. Raise the patient’s feet to 45 degrees. In the presence of poor arterial supply, pallor rapidly develops in feet.