prepared by:Salwa MaghrabiTeacher Assistant Nursing Department

Arterial Blood Gases

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 are diagnostic tests performed on blood taken diagnostic tests performed on blood taken from an artery which contains oxygen and from an artery which contains oxygen and carbon dioxide and others elements .carbon dioxide and others elements .

Indications

1- Evaluate acute

respiratory distress and

assist in determine

therapeutic interventions.

1- Evaluate acute

respiratory distress and

assist in determine

therapeutic interventions.

2- Evaluate the

effectiveness of respiratory intervention.

2- Evaluate the

effectiveness of respiratory intervention.

Cont’ Indications

3- Document the existence

and severity of a problem with oxygenation or carbon dioxide

exchange.

3- Document the existence

and severity of a problem with oxygenation or carbon dioxide

exchange.4- Analyze acid – base

balance.

4- Analyze acid – base

balance.

Contraindications and Cautions

11 - -Previous Previous surgery in surgery in the arterythe artery

2- Patient with

anticoagulant or with

known coagulopat

hy.3- Skin

infection or damage of the skin .

4- Decrease collateral

circulation.

Cont’ Contraindications and Cautions

5 -Sever atheroscler

osis

6 -Serious injury to

the extremity.

7- Fibrinolytic

therapy.

8 - Patient with

femoral graft orcellulites

8 -Patient with

femoral graft or

cellulites

Cont’ Contraindications and Cautions

9- Patients who have had a cardiac

catheterization via the brachial rout or who have sclerotic

vessels.

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 from the heart. Veins carry blood

toward the heart .

Blood is under great pressure in arteries;

hence it lows fast.

In veins the blood is not under great

pressure, hence it flows more

slowly .and smoothly

Arteries have thick and elastic muscular

walls.

Veins have relatively thin and slightly muscular walls.

Cont’ The different between the artery and the vein

ArteryVein

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.

Reference

http://copd.about.com/od/glossaryofcopdterms/g/abgs.htm

http://www.blurtit.com/q747973.html