Please select the eligibility criteria that correspond 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: Inclusion Criteria:

* Age above 18 years old.
* Scheduled for selective surgery.
* Requirement of perioperative vascular puncture and catheterization.
* American standard of anesthesia level I-IV.

Exclusion Criteria:

* Contraindication to vascular puncture or catheterization.
* Occlusion or thrombosis of target vessel evaluated by ultrasound.
* Refuse or disagreement from participants.
B: Inclusion Criteria:

* All surgical intensive care unit patients at Yale New Haven Hospital in whom the indication for arterial catheterization has been established by the attending physician will be eligible for consented randomization to either the "Palpation" or the "Ultrasound" group.

Exclusion Criteria:

* The patient or his/her surrogate declines to participate or the patient lacks a radial artery into which a catheter can be place.
C: Inclusion Criteria:

* Patients requiring arterial line placement.

Exclusion Criteria:

* Adults Unable to Consent
* Members of Vulnerable Populations
D: Inclusion Criteria:

* The subject has signed consent
* The subject is affiliated with a social security system
* Health status necessitates an arterial blood sample for diagnostic, prognostic or therapeutic reasons

Exclusion Criteria:

* The subject is participating in another study
* The subject is in a study exclusion period determined by a previous study
* The subject is under guardianship
* The subject refuses to sign consent
* Impossible to correctly inform the patient
* The patient is pregnant, breastfeeding, or parturient
* Allergies to one or more of the following: methyl, propylbenzoate, propylene glycol, chlorhexidine gluconate
* Contraindication for an arterial puncture (at the radial artery)
* Cardio-respiratory arrest

Answer: C