Abg procedure

by : Monesa Bianca Bula

BSN Irr 3 - A
What is Abg ?

• Arterial Blood Gas

• An invasive procedure

• Drawn from artery – radial , brachial , femoral , arterial

catheter

• Caution for patients taking anticoagulants

• BLOOD GAS ANALYZER

purposes

• To obtain :
– Acid base status

– Oxygenation
• Arterial oxygen tension (PaO2)

– CO2 elimination
indication
• Assess the ventilatory status, oxygenation, acid
base status of the patient

Contra indication
• Bleeding diathesis
• AV fistula
• Severe peripheral vascular disease, absence of an
arterial pulse
• Infection over site
Which Artery to Choose?
• The radial artery is superficial, has collaterals and is
easily compressed. It should almost always be the
first choice.
• Other arteries (femoral, dorsalis pedis, brachial) can
be used in emergencies.
Obtaining specimen
(blood extraction)
Procedure :
• Review patient’s chart (physicians order, laboratory data and
contraindications)
• Gather the equipments
– Protective eyewear
– Gloves
– Povidone Iodine swab
– Alcohol swab
– ABG sampling kit
• 3 cc heparinized ABG syringe
• Filter device
• Needle protection device
– 2x2 gauze
– Bag of ice
– Rolled towel
• Wash hands
• Identify client and introduce yourself
• Explain the procedure
• Perform Allen’s test
– Palpate radial artery using fingers of non-dominant hand
– Palpate ulnar artery using fingers of dominant hand
– Instruct the patient to make a fist as tight as he/she can
– Occlude the radial and ulnar artery
– After 10 seconds, instruct patient to release the fist
– Release pressure from ulnar artery (watch for reperfusion of the
hand, indicates (+) Allen’s Test)
• Put on gloves
• Tuck a rolled up towel underneath the patients wrist
• Feel the artery again
• Clean the radial area using povidone iodine and alcohol swab
• Open ABG sampling kit
• Hold the syringe like a dart 45 degrees angle with bevel up
• Feel again the pulse
• Slightly roll up the finger away and put the needle through the skin
• Enter the artery and allow the blood to fill up the syringe spontaneously (1 ½ - 2 cc of blood)
• Withdraw the needle and hold pressure on the punctured site using 2x2 gauze for 5 minutes or until bleeding has stopped
• Remove air from the syringe using the needle protection device
• Detach the needle
• Cap the syringe
• Gently mix the specimen by rolling it between your palms
• Place the specimen to the bag of ice and send it to the laboratory immediately
• Dispose needle in sharps container
• Document procedure done
 Note:
• The radial artery at the wrist is very superficial and in fact this
is one of the reasons it is so frequently used for arterial blood
gas sampling. One of the most common reasons for missing a
puncture is that the nurse misses the artery on the way
through. This is often followed by attempts to find the artery
even deeper by "poking around". This will be unsuccessful and
much to the displeasure of the patient. If you don't encounter
the artery in the superficial subcutaneous tissue you should
pull the needle back and try again.