Art Line & Cap Blood Sampling

Question 1

What can we serially monitor?

Answer 1

1- acid base (pH)
2- ventilation (co2)
3- oxygenation (o2)
4- electrolytes (Na, Cl…)
5- calculated parameters (SaO2)

Question 2

When do we insert an art line?

Answer 2

When frequent ABG’s are needed, and the benefits outweigh the risks (i.e. being ventilated for at least a week)

Question 3

Contraindications for inserting an Art Line

Answer 3

1- severe anemia/hypovolemia
2- pt not hemodynamically stable (i.e. undergoing arrest)
3- patient refuses

Question 4

Complications for an Art Line

Answer 4

1- air embolism (bubbles in smaller arteries greater risk)
2- infection
3- loss of blood
4- diminished blood flow to periphery
5- arterial necrosis (if catheter size too large for artery)

Question 5

Stopcock scenario: turned off to patient

Answer 5

flow from flush to sample port

Question 6

Stopcock scenario: turned off to flush

Answer 6

flow from patient to sample port

Question 7

Stopcock scenario: turned off to port

Answer 7

flow from flush to patient

Question 8

Stopcock scenario: turned off to all

Answer 8

at 45 degree angle, no free flow between any ports

Question 9

Describe the steps for Art Line Blood Sampling

Answer 9

• record current BP on monitor
• silence BP alarms
• turn off to all
• remove cap from sample port, place in sterile place
• wipe sample port with alcohol
• remove 3ml syringe from package using sterile technique
• attach syringe to sample port
• turn stopcock off to flush (free flow from patient to sample port)
• fill syringe until turns homogeneously red
• turn stop cock off to all ports
• remove discard syringe
• immediately attach a heparinized syringe to sample port
• turn stopcock off to flush (free flow from patient to sample port)
• withdraw 2-3 ml of blood
• turn stop cock off to all
• remove and cap syringe
• turn off to patient to allow flow from flush to sample port
• flush blood/air from sample port into sterile gauze
• wipe port with alcohol and replace cap once dried
• turn stopcock off to port to allow flush to patient, flush to blood back to patient until line clear (pulsate)
• return stopcock back to monitoring position
• engage the BP alarms
• process used supplies
• chart procedure
• complete requisition if required