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Arterial Blood Gases . prepared by: Salwa Maghrabi Teacher Assistant Nursing Department . Outlines . Definition of the arterial blood gases. Indications of the arterial blood gases . Contraindications and cautions of the arterial blood gases. The deferent between the artery and vein .

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arterial blood gases
Arterial Blood Gases

prepared by:

Salwa Maghrabi

Teacher Assistant

Nursing Department

outlines
Outlines
  • Definition of the arterial blood gases.
  • Indications of the arterial blood gases .
  • Contraindications and cautions of the arterial blood gases.
  • The deferent between the artery and vein .
  • Procedure of the arterial blood gases.
    • Preparation phase.
    • Performance phase .
  • Complications .
  • Patient teaching .
objectives
Objectives
  • Identify the arterial blood gases .
  • Mention the indications of arterial blood gases.
  • List and understand the contraindication and cautions of the arterial blood gases.
  • Discuss the variations between the artery and the vein .
  • Count the arterial puncture site .
  • Apply the procedures .
  • Enumerate the complications of the arterial blood gases.
  • List the teaching patient guide.
definition
Definition
  • Arterial blood gases (ABGs) : are diagnostic tests performed on blood taken from an artery which contains oxygen and carbon dioxide and others elements .
slide6

Indications

1- Evaluate acute respiratory distress and assist in determine therapeutic interventions.

2- Evaluate the effectiveness of respiratory intervention.

cont indications
Cont’ Indications

3- Document the existence and severity of a problem with oxygenation or carbon dioxide exchange.

4- Analyze acid – base balance.

contraindications and cautions
Contraindications and Cautions

1- Previous surgery in the artery

2- Patient with anticoagulant or with known coagulopathy.

3- Skin infection or damage of the skin .

4- Decrease collateral circulation.

cont contraindications and cautions
Cont’ Contraindications and Cautions

5- Sever atherosclerosis

6- Serious injury to the extremity.

7- Fibrinolytic therapy.

8- Patient with femoral graft or cellulites

cont contraindications and cautions10
Cont’ Contraindications and Cautions

9- Patients who have had a cardiac catheterization via the brachial rout or who have sclerotic vessels.

arterial puncture sites
Arterial Puncture sites

Redial artery , Brachial artery

Femoral artery

equipment
Equipment
  • Syringe (1-3 ml size ).
  • 20- 25 G needle with a clear hub.
  • Syringe cap.
  • Antiseptic pledgets.
  • Heparin 1:1000
  • Gauze dressing .
  • Ice container .
  • Local anesthetic .
the procedure
The procedure
  • Preparation phase :
  • 1- Patient explication .
  • 2- prepare equipment .
  • 3- Hand washing .
  • 4- select the puncture site on the base of the clinical situation , how rapidly sample must be obtained , and the circulatory status of the patient .
cont preparation phase
Cont’ preparation phase

5- if redial artery is chosen , performing modified Allen’s test is optional :

  • Elevate the patient arm for several second .
  • Have the patient to open and close the fist for several times.
cont preparation phase19
Cont’ preparation phase

6- position the extremity

  • Radial : stabilize the wrist over a small towel .
  • Brachial : place a rolled towel under the patient elbow while hyperextending the elbow .
  • Femoral : rotate the leg slightly outward .
cont the procedure
Cont’ the procedure
  • Performance phase :

1- prepare the syringe ( if not preheparinized ) .

2- Palpate the pulse and determine the point of maximal impulse.

3- Local anesthesia may be useful in anxious patient .

cont performance phase
Cont’ performance phase

4- clean the over lying skin with antiseptic solution .

5- Use the index finger of your free hand to palpate the arterial pulse just proximal to the puncture site .

6- grasp the needle as if holding a pencil, direct the needle with bevel up , and puncture the skin slowly .

cont performance phase22
Cont’ performance phase

7- When the blood appears stop advance the needle and allow the blood to flow freely into the syringe .

8- Obtain a sample of 1 to 2 ml , remove the needle from the artery , immediately apply the direct pressure to the puncture site with dry gauze for 2 to 3 minute .

a) Prepare the blood sample for the laboratory by immediately expelling the air bubbles.

cont performance phase23
Cont’ performance phase

b) Activate the needle stick safety device and remove the needle .

c) Label the syringe .

complications
Complications
  • Bleeding , hematoma, thrombosis formation.
  • Nerve injury .
  • Avoiding arterial puncture in patient who take anticoagulant medication .
  • If the air bubbles are not removed from the sample , the PO2 can increase and yield inaccurate test result .
  • The blood sample may clot if the heparin and the blood not mixed adequately.
reference
Reference
  • http://copd.about.com/od/glossaryofcopdterms/g/abgs.htm
  • http://www.blurtit.com/q747973.html