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ABG Sampling (10-15 SOLANO) .Odt

This document provides guidance on arterial blood gas (ABG) sampling procedures. It outlines indications such as evaluating respiratory status in patients with distress. Contraindications include risks of bleeding or infection at the puncture site. The steps describe properly positioning the patient, assessing blood flow, cleaning the site, administering anesthetic, inserting the needle at a 30-45 degree angle, obtaining the sample, applying pressure, and proper handling and labeling of the specimen. Post-procedure care involves monitoring for complications like infection or bleeding.

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Deomicah Solano
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283 views4 pages

ABG Sampling (10-15 SOLANO) .Odt

This document provides guidance on arterial blood gas (ABG) sampling procedures. It outlines indications such as evaluating respiratory status in patients with distress. Contraindications include risks of bleeding or infection at the puncture site. The steps describe properly positioning the patient, assessing blood flow, cleaning the site, administering anesthetic, inserting the needle at a 30-45 degree angle, obtaining the sample, applying pressure, and proper handling and labeling of the specimen. Post-procedure care involves monitoring for complications like infection or bleeding.

Uploaded by

Deomicah Solano
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as ODT, PDF, TXT or read online on Scribd
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Solano, Deomicah D.

10-15
ABG Sampling
Indications:
 Blood sampling in infants for laboratory studies unaffected by hemolysis.
 Arterial blood gas analysis for evaluating the respiratory status and acid-base equilibrium in patients with
respiratory distress or metabolic derangements.
 For routine laboratory analysis or blood culture if venous blood is difficult to obtain.

Contraindications:
 Negative modified Allen Test
-Denotes presence of ulnar artery occlusion.
 Any inflammation, infection, burns, or poor integrity at selected puncture site
 Bleeding problems or coagulopathy

Materials and Equipments needed


 Sterile gloves
 Pre-heparinized syringe
 20-, 23-, or 25-gauge needle
 Safety syringe with a needle cover that allows the syringe to be capped before transport
 Cotton/ alcohol wipe
 Alcohol or povidone-iodine
 Micropore
 Dressing
 Ice-filled container
 Local anesthetic

Steps during performance of the procedure:


1. Wash hands.
2. Introduce yourself, confirm patient details.
3. Explain procedure to the guardian and to the patient.
4. Check for contraindications.
5. Gather equipments.
6. Position the patient properly (supine) and comfortably restrain the child if needed.
7. Perform modified Allen test – this is to test adequacy of ulnar blood flow.

- Ask the patient to make a tight fist.


- Simultaneously apply pressure to the radial and ulnar arteries
- The hand will blanch
- Release pressure on the ulnar artery
- Flushing response: Color should return to the entire hand within 5-15 seconds with adequate ulnar blood
supply
- Procedure is safe to perform if entire hand flushes
1. Palpate the radial pulse (Assess its course)

2. Disinfect the puncture site following an inward to outward circular motion for 30 seconds then allow it to air dry.
3. Wash hands or disinfect hands with alcohol.
4. Don gloves.
5. Prepare and administer local anesthetic subcutaneously over the planned puncture site (making sure to aspirate
to ensure you are not within a blood vessel prior to administration). This is optional.
6. Expel the heparin through the needle.

7. Insert needle or puncture the pulse at 30-45 degree angle over the point of maximal impulse.
- Neonates have arteries that are more shallowly located. Therefore, the needle is inserted at a lesser angle
(ie. More parallel to the skin).

1. Observe blood flashback. Blood should flow freely into the syringe in a pulsatile fashion.
2. Allow syringe to fill to the appropriate level.

3. Once the sample is obtained, remove the needle and apply immediate firm, constant pressure for 5 minutes and
then place a pressure dressing on the puncture site.
Note: Do not infuse any medications, blood products, or hypotonic solutions through an arterial line.

4. Engage needle safety guard.

5. Remove needle.

6. Dispose sharp needle immediately to the sharps container.


7. Expel air bubbles, cap syringe, and roll specimen between the hands to gently mix it.
8. Label the specimen, put it in the ice-filled container.

9. Wash hands.
10. Thank the patient.
11. Send specimen to the laboratory immediately.

Post-procedural care and Complications:


 Monitor closely the patient to assess for the early signs of complications.
 If the puncture site is still bleeding, apply prolonged pressure to stop the bleeding.

Complications:
 Infection
 Bleeding
 Occlusion of artery by hematoma or thrombosis
 Ischemia if ulnar circulation is inadequate
 Post-procedure pain

Sources:
1. UST Guide for history taking and physical examination and diagnosis of pediatric patients handbook (3 rd Edition)
2. https://www.utmb.edu/policies_and_procedures/Non-
IHOP/Respiratory/Respiratory_Care_Services/07.03.40%20Neonatal%20Pediatric%20Arterial%20Puncture.pdf
3. Youtube: https://m.youtube.com/watch?v=0BSv4iN8T2E&t=31s

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