The following webpage and video tutorial will demonstrate the ideal method to cannulate the radial artery with ultrasound for obtaining invasive blood pressure monitoring. We would like to thank Dr. Jeff Odenbach, emergency physician and critical care medicine fellow, for his contribution to this section.

Key steps

Pre-procedure set-up

Please see the following image to help guide preparation for this procedure.

Probe placement

The radial artery should be imaged several cm proximal to the wrist. The image demonstrates the relevant anatomy.

Vessel patency

As a quick step, if your patient has been previously cannulated or has difficult access, you can compress the vessel (should be compressible/pulsatile) and check for flow with color Doppler. 

Local anesthetic

The following image demonstrates the ideal location to anesthetize the overlying skin.

Creep technique

Use the "creep technique" to ensure that, in the short axis, the ultrasound probe is always imaging in advance of the needle tip (and not the shaft of the needle).

Guidewire & catheter 

Once you have successfully cannulated the radial artery and have a bright red flash, thread the accompanying wire (should be little to no resistance). Once the wire is threaded, remove the needle, thread on the transducer catheter and remove the wire. Secure the catheter hub and connect the line.

Ultrasound-guided radial arterial cannulation
 Tutorial

USG A-line tutorial

Please see this fantastic tutorial from Dr. Jeff Odenbach, emergency physician and critical care fellow.