Arterial Blood Gases sample

Arterial Blood Gases sample
Presented by: Waleed Yousef BSN,RN
professional_nurses@yahoo.com WhatsApp: 0532928453 Twitter:@Nurses_Prof

Introduction:
 An arterial blood sample is collected from an artery, primarily to
determine arterial blood gases. Arterial blood sampling should only
be performed by health workers who have demonstrated
proficiency after formal training.
 The sample can be obtained either through a catheter placed in an
artery, or by using a needle and syringe to puncture an artery.
These syringes are pre-heparinized and handled to minimize air
exposure that will alter the blood gas values.

Indications for ABG:
 Severe respiratory or metabolic disorders
 Clinical features of hypoxia or hypercapnia.
 Shock.
 Sepsis.
 Decreased cardiac output.
 Renal failure.

Contraindication:
 No absolute contraindications.
 Dialysis shunt – choose another site.
 Mastectomy – use opposite side.
 Patient on anticoagulant/aspirin therapy – may have to
hold pressure on puncture site longer than normal.

Several different arteries can be used for blood collection.
The first choice is the radial artery:
 Radial artery- best site.
 located superficially, easy to palpate & stabilize.
 excellent collateral circulation via ulnar artery.
 not adjacent to large veins.
 Alternative sites for access are brachial or femoral arteries, but
these have several disadvantages in that they:
 may be harder to locate, because they are less superficial than the radial artery.
 have poor collateral circulation.
 are surrounded by structures
that could be damaged by faulty technique.
Choice of site:

There are several potential complications related to arterial
blood sampling.
 Pain.
 Hematoma, hemorrhage.
 Trauma to vessel.
 Arteriospasm .
 Air or clotted-blood emboli.
 Vasovagal response.
 Arterial occlusion.
 Infection.
Complications related to arterial blood sampling :

Sampling errors:
Inappropriate collection and handling of arterial blood
specimens can produce incorrect results. Reasons for an
inaccurate blood result include:
 presence of air in the sample;
 collection of venous rather than arterial blood;
 an improper quantity of heparin in the syringe, or improper mixing after
blood is drawn;
 a delay in specimen transportation.

Procedure steps:
1.Wash your hands, introduce yourself to the patient and clarify
their identity. Explain what you would like to do and obtain
consent. This is a slightly uncomfortable procedure so you should let
the patient know this.
 Wash your hands
 Introduce yourself to the patient

Procedure steps:
2.Gather the necessary following equipment:
 a blue (23 G) needle.
 2ml syringe with heparin.
 a cap for the syringe.
 a plastic bung.
 local anaesthetic (plus needle and syringe for giving).
 alcohol gel.
 Gauze.
 Gloves.
 a sharps bin.
 Usually, the syringe, needle, cap and bung are all provided in one pack.
 Equipment required for measuring arterial blood gases

Procedure steps:
3.Position the patient’s arm with the wrist extended.
4.Locate the radial artery with your index and middle fingers.
Perform Allen’s test where you compress both the radial and ulnar
arteries at the same time. The hand should become white, release
the ulnar artery and the color should return to the hand. This
ensures that there will still be a blood supply to the hand should
the ABG cause a blockage in the radial artery.
 Locate the radial artery with your index and middle fingers.
 Allens Test.

Procedure steps:
5.Put on your gloves and attach the needle to the heparinised syringe.
 Also prepare your local anaesthetic and give a small amount over the palpable
radial artery.
6.Take the cap off the needle,and again locate the radial artery using
your non-dominant hand.
 Remove the cap from the needle.

Procedure steps:
7.Let the patient know you are about to proceed and to
expect a sharp scratch.
 Insert the needle at 30 degrees to the skin at the point of maximum
pulsation of the radial artery. Advance the needle until arterial blood
flushes into the syringe. The arterial pressure will cause the blood to
fill the syringe.
 Remove the needle/syringe placing the needle into the bung. Press
firmly over the puncture site with the gauze to halt the bleeding.
Remain pressed for 5 minutes.
 Prepare to insert the needle.

Procedure steps:
 Remove the needle.
 Place the needle into the bung.

Procedure steps:
8.Remove the needle and discard safely in the sharps bin.
 Remove the needle from the syringe.
 Safety discard the needle into the sharps bin.

Procedure steps:
9.Cap the syringe, push out any air within it, and send
immediately for analysis ensuring that the sample is packed
in ice. Remove your gloves and dispose them in the clinical
waste bin. Wash your hands and thank the patient.
 Cap the syringe.

Procedure steps:
10.now sample is ready for analysis and to be connected to ABG
machine .

 THANK YOU
THANK YOU

Arterial Blood Gases sample

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