Arterial blood sampling who guidelines on drawing blood. The health professional taking a sample of your blood will. The information given here supplements that given in chapters 2 and 3. You may get this test if you are in the hospital because you have a serious injury or illness. Radial arterial puncture for arterial blood gas analysis is a common procedure performed in adults. S 21yearold woman who on the way to hospital has become increasingly drowsy. Decide whether to proceed with the test if a contraindication is present on the basis of how urgent the sample is. We may be presented increasingly with venous blood gases 2. Aug 15, 2018 arterial blood samples should be obtained in strict anaerobic conditions and should be placed on ice and held at 0 c until analysis. Arterial blood gas abg analysis evaluates gas exchange in the lungs by measuring the partial pressures of oxygen pao2 and carbon dioxide paco2 as well as the ph of an arterial sample.
Before you can interpret an abg you must, of course, obtain a sample of arterial blood. The following recommendations are made following the grading of recommendations assessment, development, and. Pao2 measures the pressure exerted by the oxygen dissolved in the blood and evaluates the lungs ability to oxygenate the blood. A blood gas test measures the amount of oxygen and carbon dioxide in the blood. Cord blood gas sampling procedure purpose the purpose of this guideline is to provide safe and effective care for women establish a local approach to care, that is evidence based and consistent inform good decision making scope obstetric staff employed by the hutt valley dhb. Clear, tolerating an oropharyngeal airway, on 40% oxygen via face mask. List the values typically measured by a standard blood gas analyzer list the values typically measure by a cooximeter describe the various quality control measures used to assure the accuracy of blood gas values, including leveyjennings data. Users discretion debateable for isolated sampling essential for multiple samples and insertion of line. Differences are subtle but important on venous gas. Specific recommendations of the working group are labelled by the boxes. It is performed on patients in respiratory distress, such as an. Jul 01, 2019 a blood gas test measures the amount of oxygen and carbon dioxide in the blood.
The procedure, called the modified allen test, checks that blood flow to your hand is normal. Arterial blood gas abg sampling using local anaesthetic demonstration duration. The radial artery on the wrist is most commonly used to obtain the sample. Connects abg syringe, opens stopcock, and obtains in capillary tube blood gas sample 1 cc 11. Acidbase balance overview the ph is a measurement of the acidity or alkalinity of the blood. For sampling from the radial artery using a needle and syringe, follow the steps outlined below. Arterial puncture blood gas gundersen health system. An arterial blood gas abg test measures oxygen and carbon dioxide levels in your blood.
The typical blood gas abnormality encountered in the early phase of asthma is relative hypoxemia with hypocapnia pa co 2 measurements. Arterial blood gas analysis workshop scenario 4 initial information an 18 year old man who is an insulin dependent diabetic is admitted to the accident and emergency department. The collection kit utilizes dry lithium heparin and a syringe volume preset collection system. Arterial blood gas abg interpretation for medical students, osces and mrcp paces this section presents how to interpret arterial blood gases. Mar 27, 2012 the blood sample is collected and tested in a laboratory. Blood gas values mixed venous gases measures oxygen left in the blood as it returns to the heart right side after it has been pumped around the body supplying cells with oxygen. Blood gas and ph analysis and related measurements. Arterial blood sampling who guidelines on drawing blood ncbi. It also measures your bodys acidbase ph level, which is normally balanced when you are healthy. Abgs made easy for nurses w tic tac toe method for arterial blood gas interpretation duration. By interpreting arterial blood gases test results, doctors can determine the state of the bodys lung and kidney function.
Be able to demonstrate the technique for performing an arterial puncture. The body normally extracts 25% of available oxygen and leaves 75% in reserve in times of stress or illness. However, the femoral artery and brachial artery can be used if necessary. Each recommendation is followed by relevant data from literature. B she was thrown from her horse at a local event a a. Remember there is always the other arm where the test could be performed. Pretto et al evaluated the changes in p o 2 ab for samples with a high initial partial pressure collected in a highdensity polypropylene syringe. Oct 15, 2017 an arterial blood gas abg test measures the acidity ph and the levels of oxygen and co2 in the blood from an artery. In order to prepare for an arterial blood gas test, tell your doctor about all medications. Sep 11, 2009 abgs made easy for nurses w tic tac toe method for arterial blood gas interpretation duration. Arterial blood gas is an emergency investigation sent in a patient who is breathless or in kidney failure. Dec 05, 2014 arterial blood gas abg sampling using local anaesthetic demonstration duration. Indications puncture of the radial artery is the preferred method of obtaining an arterial blood sample for blood gas analysis.
Withdraws 23 cc of bloodfluid from arterial line first drop of blood with alcohol swab 11. It is usually performed via a puncture of the radial artery at the wrist or the femoral artery at the groin. National recommendations on behalf of the croatian society of medical biochemistry and laboratory medicine article pdf available october 2016. The most important points when assessing a patient are the history, examination and basic observations. Arterial blood gases values normal ranges and procedure. The following recommendations are made following the grading of recommendations assessment. The chief indication for blood gas analysis is the. It explains each component in turn followed by clinical examples to work through. Arterial blood gas abg sampling oxford medical education. Blood is drawn anaerobically from a peripheral artery radial, brachial, femoral, or dorsalis pedis via a single percutaneous needle puncture, or from an indwelling arterial cannula or catheter for multiple samples. Arterial blood gas analysis workshop case study 1 initial information i ed staff member has asked you to assist. Approach the patient, introduce yourself and ask the patient to state their full name. Arterial blood gas analysis is an essential part of diagnosing and managing a patients oxygenation status and acidbase balance.
Arterial puncture for blood gas analysis overview radial arterial puncture for arterial blood gas analysis is a common procedure performed in medicine. Procedure for arterial blood sampling using radial artery. An arterial blood gas abg is a blood test carried out by taking blood from an artery, rather than a vein. Aarc clinical practice guideline blood gas analysis and. Arterial blood gas sampling society for acute medicine. It may also be used to determine the ph of the blood, or how acidic it is. During most blood testing procedures, blood is drawn from a vein.
A study published in thorax in 2004 examined the effect of sample storage time, temperature and syringe type on blood gas tensions in samples with high oxygen partial pressure 8. Closes 3way stopcock to port and removes syringe 10. A procedure called the allen test may be done to ensure that blood flow to your hand is normal. This chapter covers background information section 5. It is a fundamental skill that all medical trainees need to. Arterial blood gas measurements provide objective information on the adequacy of ventilation and oxygenation of the patient with asthma.
An arterial blood gas abg test measures the acidity ph and the levels of oxygen and co2 in the blood from an artery. Arterial blood gases abg cardiovascular osce skills. Any air bubbles introduced during the sampling procedure will lead to overestimation of arterial oxygen tension pao 2 and underestimation of arterial carbon dioxide tension paco 2. Gently squeezes finger heel and obtains blood sample 12. These syringes are preheparinized and handled to minimize air exposure that will alter the blood gas values. Most contraindications are relative and rarely encountered. The bradford emergency department elearning and core competency workbook. Arterial blood gas analysis is widely available in hospitals. Procedure neonatal pediatric arterial puncture policy 7. Blood gas worksheet checklist download pdf you are a new staff member working in the emergency department ed during your induction you are introduced to the practical workings of the point of care arterial blood gas abg machine in the ed. Users of these guidelines should read chapters 2 and 3 before reading the information given below.
Arterial puncture for blood gas analysis nejm youtube. A standard blood gas collection kit is used in all areas. Arterial blood gas abg sampling is a commonly performed procedure which allows healthcare professionals to quickly obtain information on a patients respiratory status blood oxygen and carbon dioxide levels, as well as the patients acidbase balance. Shares3\lab\poct\ procedurespoc current \istat procedure rev. The low ph in combination with the high pco 2 tells us that the respiratory acidosis is the primary process. Clinical and laboratory standards institute, 940 west valley road, suite 1400, wayne, pennsylvania 190871898, usa. Arterial blood is the sample type required for correct assessment of gas exchange, function of the lungs po 2 and pco 2, specifically oxygenation status. The maintenance to be carried out by the ward staff is. The blood sample is collected and tested in a laboratory. Arterial blood sampling should only be performed by health workers for whom the procedure.
This test is used to examine how well your lungs are able to move oxygen into the blood and remove carbon dioxide from the blood. It is performed so that an accurate measurement of oxygen and carbon dioxide levels can be obtained, which then allows the patients oxygen to be delivered appropriately. Arterial blood gas determinations of pco2 provide the most accurate determinations of the adequacy of alveolar ventilation, but capillary, transcutaneous, and end tidal techniques are also useful. The usefulness of this diagnostic tool is dependent on being able to correctly interpret the results. Composition of the arterial blood is uniform and it is not dependent on changes in systemic or local circulation. It may also be used to determine the ph of the blood, or how acidic. He has had been vomiting for 48 hours and because he was unable to eat, he chose to omit his insulin. Withdraws 23 cc of blood fluid from arterial line first drop of blood with alcohol swab 11. Taking an arterial blood gas abg involves using a needle and syringe to directly sample blood from an artery usually the radial artery. The patient has a low ph acidemia the pco 2 is high respiratory acidosis and the bicarbonate is high metabolic alkalosis. Know some of the indications and contraindications for performing an arterial puncture.
Arterial blood gas an overview sciencedirect topics. We searched medline, cinahl, and cochrane library database for articles published between january 1990 and december 2012. And since it is an emergency, one has to be really quick in sending one. Radial arterial puncture for arterial blood gas analysis is a common procedure per formed in adults. Aug 24, 2017 arterial blood gas is an emergency investigation sent in a patient who is breathless or in kidney failure. Analysis of arterial blood gases abg is an essential investigation in the management of critically ill patients as it provides important information about alveolar ventilation, oxygenation, and acidbase balance measurement of abg includes measurement of three parameters, i. It is a fundamental skill that all medical trainees need to acquire. May 26, 2018 an arterial blood gas abg is a blood test carried out by taking blood from an artery, rather than a vein. This method is followed in rural hospitals which do not have their own lab. Blood gas analysis should be performed by trained individuals16, 17 in a variety of settings including, but not limited to. This chapter describes only the procedure for a radial artery blood draw. How to interpret an arterial blood gas analysis lecturio.