Arterial Puncture - Phlebotomy notes PDF

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Summary

ARTERIAL PUNCTUREARTERIAL PUNCTURE Generally used to obtain specimen for blood gas analysis o Assess body’s capacity to use oxygen and carbon dioxide o Monitor maintenance of body pH (7) o Arterial blood is preferred  Arterial blood that just left heart and lungs has highest concentration of oxyge...

Description

ARTERIAL PUNCTURE ARTERIAL PUNCTURE Generally used to obtain specimen for blood gas analysis o Assess body’s capacity to use oxygen and carbon dioxide o Monitor maintenance of body pH (7.4) o Arterial blood is preferred Arterial blood that just left heart and lungs has highest concentration of oxygen o Arterial blood gas has uniform composition in all parts of body o Venous blood gas varies depending on location in body

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COLLECTION REMINDERS AND CONSIDERATIONS Patient must be in relaxed, steady state during collection Excitement or anxiety can alter breathing patterns Avoid physical activity prior to collection Use sedatives / relaxants (1% lidocaine) if patient is under stress

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POTENTIAL HAZARDS ! !

Development of hematoma Possible arteriospasm (artery moves away)

PUNCTURE SITES 1. 2. 3. 4. 5. 6. 7.

Brachial Artery Radial Artery Ulnar Artery Inguinal Artery Femoral Artery Posterior Tibial Artery Dorsalis Pedis Artery

ALLEN TEST 

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Checks for collateral arterial circulation o Ensures that an alternate artery is functional o Alternate artery will continue to supply arterial blood during collection Usually performed on the radial and ulnar artery of the hand o Radial artery is primary puncture site o Ulnar artery is the alternate artery

PROCEDURE 1. 2. 3. 4. 5. 6. 7.

Patient hand rests on table with wrist up. Patient clenches fist. Press radial and ulnar arteries using fingers. Patient unclenches fist. Presence of blanching, release pressure on ulnar artery. 15 seconds after release, palm and fingers show pink. Pink color shows that ulnar artery supplies blood circulation.

COLLECTION EQUIPMENT 

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Key components o Generally same materials as with venipuncture o Antiseptic solution (povidone-iodine), preloaded syringe with heparin solution (1,000 I.U./mL), ice water solution or ice pack / bag Plastic syringe is now preferred over glass syringe o Glass syringe now considered a sharps hazard Do not use evacuated tubes o Tube vacuum alters partial pressure of blood gas

PRE-COLLECTION    

Monitor amount of oxygen patient is receiving and expiring prior to collection Perform Allen test prior to collection No tourniquet needed Disinfect puncture site with alcohol first, followed by povidone-iodine

ARTERIAL PUNCTURE 1. 2. 3. 4. 5. 6. 7. 8. 9.

Locate artery using fingers. Disinfect using alcohol followed by iodine. Prepare needle. Place your finger over location of intended artery. Insert needle (45o angle) below the point of your finger. Needle bevel should be facing direction of blood flow. Blood will enter syringe and fill on its own. Remove needle. Place cotton and apply pressure (5 to 10 mins).

POST-COLLECTION  

Maintain pressure on puncture site for 5 to 10 minutes Properly label specimen

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Use plastic syringe if specimen will be processed within 20 minutes, transport in room temperature Use glass syringe if specimen will NOT be processed within 20 minutes, transport in ice pack....