Arterial blood obtained by percutaneous puncture of the brachial artery , radial or femoral .
Once collected , the blood can be sent to determine arterial blood gas .
Blood gas analysis is effective ventilation and blood pH measuring the partial pressure of oxygen ( PaO2 ) and carbon dioxide pressure ( PaCO2 ) . Blood pH indicates acid-base balance in the blood. PaO2 indicates the amount of O2 in the lungs transmit them to the blood , and PaCO2 indicate lung capacity to remove carbon dioxide . Can also measure blood gases and oxygen saturation concentration and bicarbonate values . Usually , blood gas analysis is recommended in patients with obstructive lung disease , pulmonary edema, acute respiratory disorders , heart attack, pneumonia. It also harvested after cardiac surgery ( bypass sites ) resuscitation in case of cardiac arrest, prolonged intraoperative anesthesia , etc. . Before performing puncture radial Allen test is performed .
Allen test :
- is used to evaluate the blood flow to the hand . First you can feel its pulse on the radial and ulnar arteries , by compression of the face deep anterior forearm .
- patient is asked to make a fist , then firmly compress both arteries between the two police ;
- further , the patient will be asked to open his fist and palm will notice that dim ( all the while maintaining compression on arteries);
- will decompress the ulnar artery (maintain compression on the radial artery ) ulnar artery is patent if i will see normal color within 3-5 seconds hand .
- will decompress the radial artery ( ulnar artery compression is maintained ) if the radial artery is patent , will become red palm bloodstream in seconds.
By this process , the maintenance of the decompression paleness after occlusion of one of the arteries indicating the level.
- 2 ml or 5 ml syringe
- vial of heparin
- fortified forest
- gauze compress ice bag ( buiotă )
- analysis request form
- adhesive bandage
Preparation of materials :
be heparinizează syringe (opens vial of heparin and pull until you fill the syringe , then slowly drain the whole syringe , allowing heparin to ” wash ” the whole surface ) . Heparinisation syringe prevents blood clotting in the syringe. However , excess heparin syringe can alter the pH values and blood PaO2 .
confirm the identity of the patient ( to avoid confusion and to never take another patient analysis )
be communicated to the patient will be informed of the procedure and what is , to reduce anxiety and ensure cooperation to
Wash hands and put gloves
sits a rolled towel under the patient’s wrist to support its
artery locate and palpate the pulse
puncture site is desinfectează
expect to disinfect dry place
they palpate the artery index and middle finger of one hand while the other hand held syringe is chosen over the puncture site
radial artery puncture , the needle is oriented at an angle of 30-45 degrees
if brachial artery puncture will be oriented at an angle of 60 degrees
they puncture the skin and arterial wall by a single motion
syringe will automatically fill with blood
after harvest compress pressed firmly until the bleeding stops (at least 5 min). If the patient is being treated with anticoagulants or clotting is the compression is maintained for 10-15 minutes . Avoid to ask the patient to keep the puncture site compression alone . If it fails to apply firm compression , it becomes a painful hematoma .
will not have to check the syringe for air bubbles ( if he will be out carefully )
shall be attached to the blood sample analysis request duly completed and will be sent to the laboratory in a container of ice
will attach an adhesive bandage for bleeding to stop
will monitor the patient’s vital signs to detect any movement disorders as: pallor , pain, drowsiness , tingling , bruising, bleeding at the puncture .
Special considerations :
if the patient receives oxygen will wait at least 15 minutes when you start to receive it until harvest
not discontinue use of oxygen during collection unless it specifically states otherwise . If you do not stop the administration of oxygen , specify the form and type of oxygen assay that patient receives
If the patient is under oxygen and this will be specified on the application form analysis
if the patient has just been put on ventilator will wait 20 min to harvest
on the application form for laboratory analysis will be more specific patient temperature , the latest level of Hb, respiratory rate , and if the patient is ventilated additionally specify : fraction of inspired oxygen , ventilatory frequency
there will be no more than 2 attempts to puncture the same place as it may damage the artery and radial nerve
achieve periosteum can cause considerable pain patient
needle perforating artery crossing the other wall ( less needle will be withdrawn until blood appears in the syringe)
appearance of arterial spasm ( it will change to a smaller needle and try again