Bedside tip
Case: After uneventful insertion of IABP (intra-aortic balloon pump) - you have been informed that, it will take a while before CXR can confirm proper location of tip of IABP. What is one easy method to determine that you have not 'over-shooted' the tip of IABP?
Answer: Check the left radial pulse
Ideally, the tip of the balloon should be positioned 2–3 cm distal to the origin of the left subclavian artery (LSCA). This position results in maximum augmentation of coronary artery flow although minimizing the risk of embolization to the cerebral vessels and occlusion of the LSCA. If you have good left radial artery pulsation, probably your tip of IABP is distal to LSCA.
Related previous pearl: Carina as a Radiographic Landmark for Positioning the IABP
