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emmedonline
Dr. Ajith Kumar J MD
Dept. of Emergency Medicne
Travancore Medicity, Kollam
India
editor
SITE
Radial artery is the commonest site as it easily accessible and more comfortable for patients.
Other common sites are femoral, brachial, dorsalis pedis.
PROCEDURE
Put on protective gloves and sit in a comfortable position facing the patient.
With the patient’s hand supinated and wrist slightly hyperextended, palpate the radial artery. Excessive hyperextension may obliterate the pulse.
Cleanse the skin with an alcohol swab .
With 25 Gauge needle, inject 1% Lidocaine indradermally to raise a wheal at the point where the skin puncture is made.
Use 22 G Needle with 5ml syringe
Wet the needle and syringe with sodium heparin (1000U/ml) . Express all excess solution.
With the needle, enter the artery at an angle of approximate 45 degrees to long axis of the vessel .
Advance the needle into a radial artery until a blood flashback appears, then allow the syringe to fill to appropriate level. DO NOT PULL BACK THE PLUNGER.
Immediately after obtaining the specimen, expel any tiny air bubbles to ensure that the specimen will be anaerobic and then cap the syringe.
Roll the blood sample between both palms for 5 -15 seconds to mix the heparin and blood.
Make a note of time drawing the sample, ventilator settings, FiO2.
MODIFIED ALLEN’S TEST
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SAMPLING ERRORS
Inappropriate collection and handling of arterial blood specimen can produce incorrect results.
Presence air in the sample
Collection of venous rather than arterial blood
Improper quantity of heparin in the syringe or improper mixing after blood is drawn.
Delay in specimen transportation.
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Complication
Arteriospasm
Haematoma
Vasovagal syncope
Updated on 18/1/2017
Reference
WHO Practice on drawing blood : Best practices in phlebotomy.2010.
Irwin & Rippe’s Intensive Care Medicine.
Importance of correct handling of samples for the results of the blood gas analysis. Harsten A.
.
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emmedonline
Dr. Ajith Kumar J MD
Dept. of Emergency Medicne
Travancore Medicity, Kollam
India
editor