Indications
- Blood gas determination
- Arterial blood sampling to determine blood chemistries.
- Poor collateral circulation.
- Skin infection near planned puncture site.
- Bleeding disorders, including thrombocytopenia, systemic fibrinolytic states and thrombolytic therapy.
Blood gas sampling kit,or 3-5 ml syringe, 1 ml heparin (1000 units/ml), alcohol or povidone-iodine swabs, and a cup of ice, 23-25 gauge needle (20-22 gauge for femoral artery), sterile gloves, sterile dressing, adhesive tape.
Procedure
1. Use a heparinized syringe for blood gas and a non heparinized syrine for chemistry determinations. Obtain a blood gas kit.
2. The radial artery is the most frequently used site for arterial blood gas sampling.
3. It may be helpful to secure the dorsum of the wrist and place gauze behind the wrist to hyperextend the joint. Elevating the wrist will often bring the radial and brachial arteries closer to the surface.
4. Prepare the area with either povidone-iodine or an alcohol swab. Hold the syringe like a pencil with the needle bevel up and enter the skin at a 60 to 90 degree angle. Maintain slight negative pressure on the syringe.
5. Aspirate very slowly. A good arterial blood sample requires only minimal back pressure. If the vessel cannot be located , redirect the needle without taking it out
of the skin.
6. Obtain about 2 -3 ml of blood.
7. To avoid a hematoma, withdraw the needle quickly and apply firm pressure at the site for atleast 5-10 min, even if the sample was not obtained. Apply a sterile dressing.
8. If the sample is for a blood gas , expel any air from the syringe, mix the contents throughly by twirling the syringe between your fingers and make the syringe air tight with a cap. Place the syringe on ice before the sample is taken to the laboratory.
Complications
- Localized bleeding
- Thrombosis of the artery.
- Infection
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