You are on page 1of 14

Ns. I Kadek Saputra, S.Kep

Ns. I Kadek Saputra, S.Kep
Ns. I Kadek Saputra, S.Kep
Ns. I Kadek Saputra, S.Kep

Introduction

To take arterial blood from arterial line

Assessment of arterial blood gases (ABG)

reveals the ability of the lungs to exchange

gases by measuring the partial pressures

of oxygen (PO2) carbon dioxide (PCO2)

and evaluates the pH of arterial blood

Blood gases are ordered to evaluate :

Oxygenation

Ventilation and the effectiveness of respiratory therapy

Acid-base level of the blood

NILAI NORMAL

Komponen

Darah Arteri

Darah Vena

pH

7.40 (7.35-7.40)

7.38 (7.33-7.43)

PO 2

80-100 mmHg

34-49 mmHg

Saturasi O 2

95% atau lebih

70%-75%

P CO 2

35-45 mmHg

41-51 mmHg

HCO 3

-

22 26 mEq/L

24 28 mEq/L

Base excess :

-2 sampai +2

0 sampai 4

Arterial blood samples

Are drawn from a peripheral artery

Radial artery Brachial artery

Femoral artery

Nursing practice perform radial artery

puncture and femoral artery puncture is

usually performed only by an advanced

practitioner (DeLaune, 2002)

The syringe is then rotated to mix the blood with the heparin to prevent clotting

S

S
S
S
S
S
S

Arterial punctures should not be performed

If the client is hyperthermic

Immediately after breathing and suctioning treatments

Less than 20 to 30 minutes after oxygen therapy or ventilator setting

Potter 2006

and suctioning treatments  Less than 20 to 30 minutes after oxygen therapy or ventilator setting
and suctioning treatments  Less than 20 to 30 minutes after oxygen therapy or ventilator setting
Arterial samples are also contraindicated in :  Anticoagulant therapy  Clotting disorders  Symptomatic
Arterial samples are also contraindicated in :  Anticoagulant therapy  Clotting disorders  Symptomatic

Arterial samples are also contraindicated in :

Anticoagulant therapy

Clotting disorders

Symptomatic peripheral vascular disease

Negative Allen test

:  Anticoagulant therapy  Clotting disorders  Symptomatic peripheral vascular disease  Negative Allen test
:  Anticoagulant therapy  Clotting disorders  Symptomatic peripheral vascular disease  Negative Allen test

Allen test

Have client tight fist and rise hand above heart

Apply direct pressure to both arterial and ulnar artery

Have client lover hand and open hand

Release pressure ulnar artery; observe color of fingers, thumb, and hand

 Have client lover hand and open hand  Release pressure ulnar artery; observe color of
 Have client lover hand and open hand  Release pressure ulnar artery; observe color of
 Have client lover hand and open hand  Release pressure ulnar artery; observe color of

Allen’s test result :

Flushing can be seen immediately if flow through

ulnar artery is good. Allen’s test is positive, verifying

ulnar artery alone is capable to providing blood

supply to entire hand. Therefore radial artery can

be used to for puncture

If there is not flushing in 15 second, Allen’s test is negative, and this test should be repeated on other

arm

If both hand give negative result, another artery

(femoral) need to chosen for puncture

Regardless of who performs the arterial puncture

Nurse is responsible for assessing the client for symptoms of bleeding or

occlusion postpuncture

Direct pressure must be applied to the puncture site until all bleeding has

stopped, a minimum of 5 minutes

Ensure that all bleeding has stopped before releasing the pressure

Symptoms of impaired circulation include

Numbness and tingling

Bluish color

Absence of a peripheral pulse

Symptoms of impaired circulation include  Numbness and tingling  Bluish color  Absence of a
Symptoms of impaired circulation include  Numbness and tingling  Bluish color  Absence of a

Procedure

Procedure
Procedure
Procedure