What is a positive allens test?
Good collateral circulation
When should a blood sample be kept in ice?
If it is going to take longer than 30 minutes to get analysed, this is to limit ongoing metabolism in the blood cells, otherwise it might result in an increased CO2, decreased pH and decreased PaO2.
What are contraindications for arterial blood gas?
Presence of AV fistula on the arm
Cellulitis broken skin or other signs of infectoin
No palpable radial pulse
Negative allens test
What are potential complications of arterial blood gas?
Fear and anxiety
Radial nerve damage
Embolus and thrombosis
Anaphylaxis to lidocaine
What equipment do you need for arterial blood gas?
- Clean Tray
- Heparinised ABG syringe kit
- Gloves, unsterile
- Apron (as needed)
- Several alcohol swabs or alternative agent (as per local policy)
- Sharps container
- Cotton ball / gauze swab
- Alcohol based hand gel
- Hypoallergenic tape
- Orange clinical waste bag
What do you need to do before performing hand hygiene?
Check for contraindications
Check patient isn't allergic to LA
Gather and open equipment
Expel air from syringe
NOTE AND RECORD FiO2
Perform hand hygiene
What should you do after performing hand hygiene?
Perform Allens test
What should you do after performing hand hygiene for the second time?
Apply gloves, prep finger of non-dominant hand for re-palpation of the artery
Ensure patient is comfortable
Take cap off needle
Extend patient's wrist approximately 30 degrees downward palm up
Enter needle (30 - 45 degree angle)
Fill syringe with 1-2 mls
Remove needle and apply pressure for 5 minutes
Apply protective shield over needle and discard
Place cap on syringe and expel all air bubble from the sample if there are any