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Peripheral arterial line - infants

PAL - infants; Art line - infants; Arterial line - neonatal

A peripheral arterial line (PAL) is a small, short, plastic catheter that is put through the skin into an artery of the arm or leg. Health care providers sometimes call it an "art line." This article addresses PALs in babies.

WHY IS A PAL USED?

Providers use a PAL to watch your baby's blood pressure. A PAL can also be used to take frequent blood samples, rather than having to stick a baby repeatedly. A PAL is often needed if a baby has:

  • Severe lung disease and is on a ventilator
  • Blood pressure problems and is on medicines for it

HOW IS A PAL PLACED?

First, the provider cleans the baby's skin with a germ-killing medicine (antiseptic). Then the small catheter is put into the artery. After the PAL is in, it is connected to an IV fluid bag and blood pressure monitor.

WHAT ARE THE RISKS OF A PAL?

Risks include:

  • The greatest risk is if the PAL stops blood from going to the hand or foot. Testing before the PAL is placed can prevent this complication in most cases. The NICU nurses will carefully watch your baby for this problem.
  • PALs have a greater risk for bleeding than standard IVs.
  • There is a small risk for infection, but it is lower than the risk from a standard IV.

References

Santillanes G, Claudius I. Pediatric vascular access and blood sampling techniques. In: Roberts J, ed. Roberts and Hedges' Clinical Procedures in Emergency Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 19.

United States Centers for Disease Control Healthcare Infection Control Practices Advisory Committee. 2011 guidelines for the prevention of intravascular catheter-related infections. www.cdc.gov/hicpac/BSI/02-bsi-summary-of-recommendations-2011.html. Accessed February 4, 2016.

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Review Date: 11/3/2015

Reviewed By: Kimberly G. Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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