Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Ultrasound Guided Versus Landmark Guided Arterial Line Placement by Emergency Medicine Interns
Brief Summary: Critically ill patients in the emergency department commonly require arterial line placement for continuous direct blood pressure monitoring, frequent arterial blood gas sampling, and frequent blood sampling. Trans-radial catheterization has been shown to reduce access site complications and increase patient comfort compared to trans-femoral access. Radial artery access on the first attempt is optimal; attempts at reentry delay care and increase the risk of vascular spasm, hematoma, infection, neurovascular injury, and pain. The traditional pulse palpation method of radial artery cannulation can be challenging, especially in patients with weak pulses (i.e. morbidly obese or hypotensive individuals).

A review of literature suggests that ultrasound guided trans-radial catheterization compared to standard pulse palpation reduces access time and increases rate of first-entry success when performed by physicians trained in ultrasound. Thus, complications ascribed to reentry are prevented and timely care is provided.

To the investigator's knowledge, only one other prospective study has been conducted to assess the utility of ultrasound guided radial artery cannulation in the emergency department. Due to the paucity of literature to support the use of ultrasound guided trans-radial catheterization in critically ill patients, the study will aim to provide further data on the topic. Both techniques are considered standard of care.


Options:
A: Arm Label: Dynamic; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: dynamic | Arm Label: Regular-triangle; Type: PLACEBO_COMPARATOR; Interventions: Behavioral: Regular-triangle | Intervention Type: BEHAVIORAL; Name: dynamic; Assigned to Arm(s): Dynamic | Intervention Type: BEHAVIORAL; Name: Regular-triangle; Assigned to Arm(s): Regular-triangle
B: Arm Label: Ultrasound radial artery catheter; Type: EXPERIMENTAL; Interventions: Procedure: Ultrasound guided radial artery catheterization. | Arm Label: Palpation based artery catheterization; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Blind insertion of radial artery catheterization | Intervention Type: PROCEDURE; Name: Ultrasound guided radial artery catheterization.; Assigned to Arm(s): Ultrasound radial artery catheter | Intervention Type: PROCEDURE; Name: Blind insertion of radial artery catheterization; Assigned to Arm(s): Palpation based artery catheterization
C: Arm Label: Ultrasound Guided A-Line Placement; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Arterial Line Placement | Arm Label: Landmark Guided A-line Placement; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Arterial Line Placement | Intervention Type: PROCEDURE; Name: Arterial Line Placement; Assigned to Arm(s): Landmark Guided A-line Placement, Ultrasound Guided A-Line Placement
D: Arm Label: With ultrasound guidance; Type: EXPERIMENTAL; Interventions: Procedure: Artery puncture with ultrasound guidance | Arm Label: Without ultrasound guidance; Type: ACTIVE_COMPARATOR; Interventions: Procedure: Artery puncture without ultrasound guidance | Intervention Type: PROCEDURE; Name: Artery puncture with ultrasound guidance; Assigned to Arm(s): With ultrasound guidance | Intervention Type: PROCEDURE; Name: Artery puncture without ultrasound guidance; Assigned to Arm(s): Without ultrasound guidance

Answer: C