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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