L5: Arterial Puncture Flashcards
blood is obtained/ widrawn from a patient’s artery
arterial puncture
blood sample is collected without tourniquet
arterial puncture
arterial puncture is used in?
blood gas analysis/ arterial blood gas analysis (ABGA)
oxygenated blood with a bright red color
arterial blood
arterial puncture is performed by whom?
MD
Nurses
Medical technologists & technicians
Respiratory therapists
Emergency medical technicians
Level II phlebotomists
sites for arterial puncture
radial, brachial, femoral, scalp, umbilical, dorsalis pedis arteries
- Good collateral circulation (radial & ulnar arteries)
- Easy to palpate (close to surface of skin)
- Less chance of hematoma formation after collection
what artery?
radial artery
- Requires considerable skill to puncture it successfully due to small size
- Difficult to locate on patients with hypovolemia or low cardiac output
what artery?
radial artery
- Large & relatively easy to palpate & puncture
- Sometimes the preferred artery for a large volume of blood
- Adequate collateral circulation (but not as good as radial)
what artery?
brachial artery
- Deeper & can be harder to palpate than radial artery
- Lies close to basilic vein; risk of mistakenly puncturing it
- Lies close to median nerve; risk of pain & nerve damage
- Increased risk of hematoma formation
what artery?
brachial artery
Largest artery used for arterial puncture
femoral artery
- Located superficially in groin, lateral to pubis bone
- Performed primarily by physicians & specially trained emergency room personnel
- Generally used only in emergency situations or when no other site is available
what artery?
femoral artery
- Large & easily palpated & punctured
- Sometimes, only site where arterial sampling is possible
what artery?
femoral artery
- Poor collateral circulation
- Lies close to femoral vein; risk of mistakenly puncturing it
- Increased risk of infection due to location & pubic hair
- Risk of dislodging plaque buildup from inner artery walls
- Requires extended monitoring for hematoma formation
femoral artery
disadvantages of arterial puncture
- Technically difficult
- Potentially more painful & hazardous than venipuncture
- Thus, not normally used for routine blood tests
- Best specimen for evaluating respiratory function
- Has high oxygen content & consistency of composition
arteial blood
used in diagnosis and management of respiratory disorders
Arterial Blood Gas
Provide valuable info. about patient’s:
- Oxygenation
- Ventilation
- Acid-base balance
Arterial Blood Gas
- Used in management of electrolyte & acid-base balance in patients with diabetes & other metabolic disorders
- Specimens are sensitive to effects of preanalyticalerrors
arterial blood gas
a measure of acidity/ alkalinity of blood (acidosis or alkalosis)
analyte? range?
analyte: pH
normal range: 7.35-7.45
Partial pressure of O2 dissolved in arterial blood
analyte? normal range?
analyte: PaO2
normal range: 80 - 100 mm Hg
partial pressure of CO2 dissolved in blood
analyte? normal range?
analyte: PaCO2
normal range: 35-45 mm Hg
a measure of bicarbonate in blood
analyte? normal range?
analyte: HCO2
normal range: 22-26 mEq/ L
percent O2 bound to hemoglobin
analyte? normal range?
analyte: O2 sat
normal range: 97% - 100%
a calculation of nonrespiratory part of acid base balance
analyte? normal range?
analye: base excess
normal range: -2 to +2 mEq/ L
in arterial puncture, what are the infos concerning conditions at a time of collection is needed?
- current body temp
- respi rate
- ventilation status
- fraction of inspired oxygen
- prescribed flow rate in liters per minute
PPE for arterial puncture
- Fluid-resistant lab coat, gown, or apron
- Gloves
- Face protection
equipment and supplies for arterial puncture
- Antiseptic Local anesthetic (optional)
- Sharp, short-bevel hypodermic needle
- 1- to 5-mL self-filling syringe
- Luer-tip normal or bubble removal cap
- Coolant
- 2- by 2-in. gauze squares
- Self-adhering gauze bandage
- ID & labeling materials
- Puncture-resistant sharps container
Modified Allen test procedure
- Have patient make a tight ____
- Compress patient’s ____ & ____ arteries at same time
- Maintaining _____, have patient open hand slowly
- Lower patient’s hand & release pressure on ____ artery only
- Assess results: +hand flushes pink; -hand does not flush pink
- Record results on _______
- fist
- radial, ulnar
- pressure
- ulnar
- requisition
in doing arterial puncture, apply pressure on the wrist using the ___ and ___ fingers of both hadns. Simultaneously compress the patient’s ___ and ___ arteries
middle, index
radial, ulnar
in arterial puncture, what artery do you release first?
ulnar artery
how do you evaluate the resultsof modified allen test procedures?
+ if the hand flushes pink
- if the hnd does not flash pink; the circulation of ulnar artery is not sufficient thus, radial artery should not be punctured.
in arterial puncture, when preparing and administering local anesthetic, insert the needle into the skin at site at angle of __ degrees
10
how many mins before proveeding w arterial puncture
1 -2 mins
in doing radial ABG procedure, insert the needle at __ to ___ degree angle, slowly direct it toward ___, and stop when a flash of bood appears
30 - 45
pulse
hazards and complications involving arterial puncture
Arteriospasm
Artery damage
Discomfort
Infection
Numbness
Thrombus formation
Vasovagal response
sampling errors involving arterial puncture
Air bubbles
Delay in analysis
Improper mixing
Improper syringe
Obtaining venous blood by mistake
Use of improper anticoagulant
Use of too much or too little heparin
criteria for ABG specimen rejection
air bubbles in the specimen
clotted specimen
hemolyis of the specimen
improper/ absent ID
improper transpo temp
inadequate volume for the test
prolonged delay in the delivery to lab
wrong type of syringe used
