Femoral Artery Pseudoaneurysm in IV Drug User

You are the anaesthetist allocated to the emergency theatre at a tertiary hospital. You attend the holding bay to assess your next patient, who is a 30-year-old woman booked for an open repair of a right common femoral artery pseudoaneurysm. She has a history of substance use disorder and the injury is a result of self-injection. The 18-gauge intravenous cannula inserted under ultrasound guidance in the emergency department is no longer patent. There is a radial arterial line in-situ. Prehospital and emergency department management has included: Ketamine 50 mg intravenously Fentanyl 100 mcg (in aliquots) intravenously Hartmann's solution one litre intravenously The patient's biometric data and results of an arterial blood gas are included below. Biometric data Height 1.70 m Weight 50 kg Body mass index 17.3 kg/m2 Body surface area 1.51 m2 Ideal body weight 61 kg Arterial blood gas (FiO2 0.44, Temperature 38.0°C) pH 7.30 (7.35-7.45) pCO2 32 mmHg (35-45) pO2 120 mmHg (80-100) Bicarbonate 15.2 mmol/L (21-28) Base excess -9.9 mmol/L (-3.0-3.0) Lactate 3.5 mmol/L (<1.3) Haemoglobin 108 g/L (115-160) Na+ 131 mmol/L (137-147) K+ 5.7 mmol/L (3.5-5.0) Ca2+ 0.75 mmol/L (0.85-1.25) Cl- 108 mmol/L (96-109) Glucose 6.4 mmol/L (3.0-7.7)