How to properly handle an arterial puncture blood gas sample

Summary

This instructional video demonstrates the proper technique for collecting blood gas samples from the radial artery using a syringe. It outlines the necessary materials, including a syringe with lithium heparin, and emphasizes the importance of patient preparation and site cleanliness. The video guides through the steps of locating the artery, drawing blood, and handling the sample to prevent clots and ensure accurate results within a 30-minute window post-collection.

Takeaways

• 🩸 Blood gas sample collection is crucial for testing vitals in critically ill patients.
• 🔍 Blood gas analysis provides information on gases, electrolytes, metabolites, total hemoglobin, CO-oximetry, and neonatal bilirubin.
• 📋 Follow local hospital procedures for patient and site preparation before collecting a blood sample.
• 💉 Use a syringe with a safety needle and electrolyte-balanced lithium heparin as the anticoagulant for blood gas analysis.
• 👁️ Confirm the patient's identity and check for adequate circulation with a modified Allen's test if possible.
• 🚫 Avoid using skin cleaning wipes containing quaternary ammonium substances as they may affect electrolyte parameters.
• 📍 Locate and clean the radial artery site properly before puncturing.
• 💉 Puncture the skin at a 45-degree angle, following the path of the artery, and collect the desired blood volume.
• 🩹 Apply pressure to the puncture site until bleeding stops, then safely dispose of the needle.
• 🔄 Mix the sample thoroughly by rotating the wrist for at least 20 seconds to dissolve heparin and prevent clot formation.
• ⏳ Blood gas testing should be completed within 10 to 30 minutes after drawing the sample for accurate results.
• 🗂️ Label the syringe with patient ID and transport the sample immediately to the blood gas system for analysis.

Q & A

What is the purpose of the instructional video?

The video is an instructional guide on how to properly collect a blood gas sample from the radial artery using a syringe.

Why is blood gas analysis performed?

Blood gas analysis is performed to test vitals in critically ill patients and provides information on gases, electrolytes, metabolites, total hemoglobin, CO-oximetry, and neonatal bilirubin.

What are the three common sites for blood gas sample collection mentioned in the video?

The three common sites for blood gas sample collection are radial, brachial, and femoral sites.

What type of syringe should be used for blood gas analysis?

A syringe with a safety needle and dry, electrolyte-balanced lithium heparin as the anticoagulant in a concentration of approximately 23 international units per milliliter should be used.

How should the patient's identity be confirmed before performing the arterial draw?

The patient's identity should be confirmed by checking their medical records or identification bands to ensure the correct patient is being sampled.

What is a modified Allen's test, and why is it performed?

A modified Allen's test is a procedure to check for adequate circulation in the hand by temporarily occluding the radial and ulnar arteries and observing the color change. It is performed to ensure the patient has good blood flow before taking the sample.

Why should the site be cleaned and allowed to dry before collecting the blood sample?

The site must be cleaned to prevent infection and allowed to dry to avoid any interference with the sample's electrolyte parameters, particularly sodium, which can be affected by substances like benzalkonium in skin cleaning wipes.

How should the syringe be held during the puncture of the radial artery?

The syringe should be held like a pencil with the bevel visible, ensuring the needle follows the path of the artery at a 45-degree angle.

What should be done after collecting the blood sample and before transporting it to the analyzer?

After collecting the blood sample, the needle should be withdrawn, pressure applied to the puncture site, the safety needle closed, and the filter cap placed on the syringe. The sample should then be mixed thoroughly by rotating the wrist for at least 20 seconds to dissolve the heparin and minimize clot formation.

What is the recommended time frame for completing blood gas testing after drawing the sample?

According to the CLSI Guidelines, blood gas testing should be completed within 10 minutes, and not longer than 30 minutes after drawing the sample to ensure accurate results.

Why should the first few drops of blood be expelled before presenting the sample to the analyzer?

Expelling the first few drops of blood helps to remove any contaminants or air bubbles that may have entered the syringe during the collection process, ensuring the accuracy of the blood gas analysis.