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Ward

Practical Skills

ARTERIAL BLOOD GAS TECHNIQUE

 
1. INTRODUCTION 
- Check the patient’s notes for anticoagulant therapy or clotting abnormalities
- Note any supplementary oxygen and the patient’s temperature
- Gather the appropriate equipment
- Make sure you know the code to use the ABG machine and where it is!

 

2. EQUIPMENT REQUIRED 
- Non-sterile gloves
- Alcohol wipes or Chlorhexidine spray
- Heparinised 2ml syringe
- Gauze and tape
- Sharps bin
- Note some people infiltrate with LA first

 

3. THE PROCEDURE 
- Clean your hands with alcohol gel
- Dorsiflex the patients wrist (makes the artery more superficial)
- Palpate the radial artery over the head of the radius
- Clean the area with an alcohol wipe
- Palpate the area of maximum pulsation of the artery and release any pressure so you are not occluding it
- Insert the needle at 30 degrees to the skin
- Advance the needle into the skin until you get flashback- in some cases the syringe will rise due to arterial pressure (sometimes you will have to aspirate).
- Allow the syringe to fill up to 2ml of arterial blood
- Withdraw the needle and press of the puncture site with the gauze
- Tape the gauze in situ and ask the patient to press down on it with their fingers for 5 minutes
- Discard the needle into a sharps bin
- Put on the bung and expel any air from the syringe so blood in contact with bung

 

4. FINISHING OFF 
- Clear up the equipment
- Take the sample immediately to a blood gas- sampling machine for analysis
- Just before squirt in machine squirt a little out of end into sharps bin in case there's a clot there
- Don't throw away sample until got result

 

Notes 
- Common sites include the radial, brachial and femoral arteries
- If selecting a radial artery, ensure the ulna artery is functioning beforehand
- Remember that the radial artery goes from medial to lateral as it goes distally towards the hand

 

 

Author: Johno Breeze 
Last updated: 09.02.15