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Arterial Blood Sampling (ABG)

Assess indications and explain procedure to patient/family. A specific surgical consent is not generally obtained.

Indications:

·         To access PH, PO2, PCO2 (note: PO2 may often be obtained by pulse ox).

·         Inability to obtain venous sample.

Contraindications:                                                     

·         Skin infection 

·         Relative Bleeding diathesis                                            

Equipment:

1.       ABG kit

2.       Ice

Procedure:

      Choose site for arterial puncture:

1.       Radial- No adjacent nerve or vessels  (Figure 1)

      Assess for adequate ulnar artery circulation:

      Position wrist in extension

      Palpate arterial pulse

      Clean skin

      Consider subcutaneous Lidocaine

      Insert needle at 30º - 40º angle  (See Figure 2)

 

In adults with adequate blood pressure, the syringe will “fill itself”; in hypotensive patients or children, the sample will need to be aspirated.

                        Remove needle, apply pressure for 5 mins. or until bleeding is controlled.

 

2.       Brachial arterial puncture:

            Position elbow in extension

            Same technique

 

3.       Femoral arterial puncture:

            Position patient supine with hip extended and slightly, externally rotated

            Same technique

                                                                       

                       

 

 

                                                           

 

Complications: Prevention and Management

 

Complication:

Prevention:

Management:

Hematoma:

Assessing the likelihood of   bleeding.

Adequate pressure.

Infection:

Aseptic technique.

(No acute)

Tendon or Nerve Damage

Appropriate positioning

(No acute)