Femoral artery, femoral vein, and inguinal region
The groin, where the main artery and vein of the leg pass under the inguinal ligament and run just below the skin crease, with the artery outside the vein.
Why the exam cares
The femoral artery is a common entry site for cardiac catheterization and angiography, so the nurse keeps the leg straight, watches the puncture site, and compares the pulses below it. The femoral vein can hold a central line, which the nurse guards against infection and clots.
How to find it
- Find the inguinal ligament: it runs from the bony point at the front of the hip (anterior superior iliac spine) down and inward to the pubic tubercle, the small bump on the pubic bone just off the midline. The groin crease roughly follows it.
- Find the point halfway between the anterior superior iliac spine and the pubic symphysis (the midline joint of the pubic bones). Press firmly just below the crease there and the femoral artery pulses under your fingers.
- The femoral vein lies just toward the midline from the artery. The femoral nerve lies just to the outside of it.
Procedure
Leg checks after femoral catheterization
After a femoral catheterization the patient keeps the leg straight with the head of the bed no higher than about 30 degrees for the ordered bed-rest time. The nurse compares pedal pulses, color, warmth, sensation, and capillary refill of that foot with the other foot, because a clot or hematoma can cut off blood flow to the leg. A cool, pale, or pulseless foot is reported at once.
Emergency
Bleeding at the groin puncture
If the site bleeds or a hematoma grows, the nurse presses firmly just above the skin puncture, because the hole in the artery sits slightly higher than the hole in the skin, and keeps pressing while calling for help. New back or flank pain with a falling blood pressure and rising heart rate points to bleeding behind the abdomen (retroperitoneal bleed), which may show no blood at the site, and is reported right away.
Pulse point
Femoral pulse in children and shock
In an unresponsive child the nurse checks the carotid or femoral pulse (the brachial in an infant) for no more than 10 seconds, and starts compressions if there is no definite pulse, or if the heart rate is under 60 with poor perfusion despite breathing support. The femoral is a central pulse, so in shock it often can still be felt after the radial and pedal pulses are gone. A weak or fading femoral pulse means shock is far along, so the nurse calls the rapid response team at once.
Procedure
Femoral central line
In adults a femoral central line carries a higher infection risk than a line in the chest or neck, because the groin is warm, moist, and near the perineum, and it also carries a higher risk of deep vein clot. The nurse keeps the dressing clean, dry, and intact, watches for redness, drainage, fever, and a swollen leg, and asks each day whether the line is still needed.