Q: In clinical practice which approach is better for arterial catheter insertion (A-Line) - select one 

A) direct puncture 
or
B) guidewire approach?


Answer:  B

In clinical practice, guidewire approach is found to be more efficient than direct puncture (catheter over needle) in cannulation of arterial lines.  Guidewire approach takes less time to perform, require lesser number of catheters, and lesser number of attempts than the direct puncture approach.


References: 

1. Beards SC, Doedens L, Jackson A, Lipman J. A comparison of arterial lines and insertion techniques in critically ill patients. Anaesthesia 1994; 49:968. 

2. Mangar D, Thrush DN, Connell GR, Downs JB. Direct or modified Seldinger guide wire-directed technique for arterial catheter insertion. Anesth Analg 1993; 76:714.