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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 .
   Procedure of the arterial blood gases.
     Preparation phase.
     Performance phase .

   Complications .
   Patient teaching .
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
   Arterial blood gases (ABGs) : are diagnostic
    tests performed on blood taken from an artery which
    contains oxygen and carbon dioxide and others
    elements .
              Indications

 1- Evaluate acute
respiratory distress
    and assist in
      determine
     therapeutic
   interventions.      2- Evaluate the
                       effectiveness of
                          respiratory
                         intervention.
          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

                      2- Patient with
   1- Previous
                     anticoagulant or
  surgery in the
                       with known
      artery
                      coagulopathy.


 3- Skin infection     4- Decrease
  or damage of          collateral
     the skin .        circulation.
Cont’ Contraindications and Cautions


                          6- Serious
     5- Sever
                         injury to the
  atherosclerosis
                          extremity.



                        8- Patient with
  7- Fibrinolytic
                       femoral graft or
     therapy.
                           cellulites
Cont’ Contraindications and Cautions



       9- Patients who have had a
      cardiac catheterization via the
        brachial rout or who have
             sclerotic vessels.
 The different between the artery and
 the vein
          Artery                          Vein
 Arteries receive the blood Veins carry blood toward
      from the heart .                 the heart .
   Blood is under great         In veins the blood is not
pressure in arteries; hence it   under great pressure,
          lows fast.           hence it flows more slowly
                                     .and smoothly
  Arteries have thick and       Veins have relatively thin
   elastic muscular walls.     and slightly muscular walls.
Cont’ The different between the artery
and the vein
          Artery                      Vein
Arteries have no valves.   In the vein there is internal
                           valve.

Fresh red in color .       Dark red in color .
Arterial Puncture sites
 Redial artery , Brachial
         artery
                            Femoral artery
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
•   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
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’ Allen’s test
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
•   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
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 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 phase
 b) Activate the needle stick safety device and
    remove the needle .
 c) Label the syringe .
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.
           Patient teaching


                     2- Report any bleeding ,
1- Do not rub the     numbness or tingling
  puncture site.      following the arterial
                            puncture.
Reference
   http://copd.about.com/od/glossaryofcopdterms/g
    /abgs.htm
   http://www.blurtit.com/q747973.html

				
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posted:7/31/2012
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