The radial  artery pulse is palpated carefully just above the radial styloid process and  the radial artery is fixed between the middle and index finger of left hand of operator  and have a mental makeup of radial course between two fingers. 20G Jelco is  used for puncturing the radial artery. 2-.3 ml of 2% Xylocaine is injected subcutaneously  over the puncture site after pinching the  skin of local area and a bleb was produced.  Now 20G Jelco with beveled end upward is used to puncture at 20 -30 angulation.  Once the radial artery Is punctured, a gush  of blood will come to needle hub of Jelco. Then  counter puncture  is done to transfix the  radial artery. The needle is withdrawn from the cannula. After that the cannula   is very slowly withdrawn keeping it  horizontal to patients arm. Once the  arterial  blood comes out of the cannula, a 0.25 short Terrumo wire (supplied with  Terrumo punctured kit) is introduced through   the cannula  to radial artery. A  small nick done over the skin and the Terrumo puncture kit (5F for diagnostic  purpose and 6F for intervention) was introduced over the wire. The dilator and  wire withdrawn and radial punctured was established. 
               |