Arterial Blood Gases Sampling

Learning Objectives:

1. Explain to the patient regarding the procedure

2. Demonstrate a proper technique of Arterial Blood Gases sampling.

Equipment:

1. Gloves
2. Pre-heparinized arterial blood gas syringe and bung or cap and needle
3. Alcohol wipe (70% isopropyl)
4. Sterile gauze or cotton wool
5. Adhesive tape

Procedures:

1. Introduce yourself to the patient including your name and role.

2. Confirm the patient’s name and date of birth.
3. Explain the procedure to the patient using patient- friendly language: including
why and how the ABG sampling is done. In addition to any possible complications.
Tell the patient that the procedure may be uncomfortable but that everything will be
done to alleviate the discomfort.
4. Gain consent.
5. Hand washing
6. Ensuring privacy and dignity
Choosing a site: The radial artery at the level of the radial styloid is the usual site of
choice as it is both superficial and easily accessible. If the vessel is not obviously
palpable, it is also possible to sample arterial blood at the brachial artery in the
antecubital fossa or femoral artery just distal to the inguinal ligament.

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7. Position for radial artery sampling: the patient appropriately: sitting comfortably
with arm placed on a pillow, forearm supinated, wrist passively dorsiflexed.
8. Confirm ulnar arterial supply to the hand before starting (modified Allen’s test):
Compress the radial and ulnar arteries with your thumbs then ask the patient to make
a fist and open it. The hand should appear blanched. Release pressure from the ulnar
artery and watch the palm. The palm should flush to its normal color.
If not, there may be inadequate ulnar arterial supply and damage to the radial artery
during blood taking may result in critical ischemia.
9. Put on your gloves.
10. Identify the radial artery with index and middle fingers of your non-dominant hand.
11. Clean the site, beginning centrally and spiraling outwards.
12. Whilst the sterilizing solution dries, remove the needle and syringe from packaging
and attach the needle to the end of the syringe. • Eject excess heparin from the
syringe through the needle.
13. Warn the patient to expect a ‘sharp scratch’.
14. Whilst palpating the artery (but not obliterating the pulsation), insert the needle just
distal to your fingertips, bevel facing proximally, at an angle of 45‒60° until a
flashback is seen within the needle chamber.
15. Hold the syringe steady and allow it to fill itself with 1-2ml blood.
16. As you withdraw the needle, apply the gauze swab to the site, maintaining firm
compression for at least 2 minutes then apply adhesive tape.
17. Dispose of the needle and apply a vented cap, expelling any excess air.
18. Document the procedure in details.