General Laboratory: Blood Gas: Sample Collection and Proper Handling: Arterial Puncture

Blood gas sample collection and proper handling. This is an instructional video about how to collect a blood gas sample from the radial artery using a syringe. Follow your local hospital procedures to prepare the patient. An collection site for obtaining the blood sample. These are the collection sites, radial brachial and femoral sites. Blood gas analysis is performed to test vitals in critically ill patients. Blood gas analysis gives information on gases. And may also include electrolytes, metabolites, total hemoglobin, Co oximetry, and neonatal bilirubin. Please ensure you have all the materials you need to draw a patient sample. This includes a syringe, typically with a safety needle, a filter cap, and alcohol. Wipe, gauze and bandage. The syringe used for blood. Gas analysis should include dry electrolyte balanced lithium heparin as the preferred anticoagulant in a concentration of approximately 23. International units per milliliter before performing the arterial draw confirm the patient's identity check for adequate circulation by performing a modified Allens test. If possible, locate the radial artery. Clean the site. Do not use a skin cleaning wipe that contains quartenary ammonium substance, such as benzalkonium as it may affect the electrolyte parameters reported, particularly sodium. Let it dry. Preset the syringe plunger to the desired sample volume. Using your index and middle fingers, identify the path of the artery. Hold the syringe like a pencil with a bevel visible. Flex the wrist slightly if need be by resting the lower arm on the edge of a bed or using a small rolled up gauze or towel under the wrist. Puncture the skin at a 45 degree angle, making sure the needle follows the path of the artery. Stop insertion when you see the blood flash or flow of blood in the syringe. Hold the syringe in place until the desired blood volume is collected. Withdraw the needle and apply pressure to the puncture site with gauze until blood flow at the puncture site has stopped. Close the safety needle with one hand and discard the needle as per the hospital's procedure. Place the filter cap on the syringe luer tip and hold the syringe vertically and gently tap the syringe so that air bubbles are forced to the top. Expel any air bubbles into the filter cap. Mix the sample thoroughly by rotating your wrist back and forth for a minimum of 20 seconds. This helps to dissolve the heparin, an minimize clot formation in the syringe. Label the syringe with the patient ID and immediately transport the sample to a Siemens healthineers blood gas system. Follow a two step mixing process first by rotating your wrist back and forth and then rolling the syringe between your hands about 10 times. Remove the cap from the syringe and expel the first few drops of blood into a gauze pad. Present the sample to the analyzer and start analysis. Recognize that a sample containing blood clots should not be used on the blood gas analyzer because it can affect not only the accuracy of the patient results, but also negatively impacts the operation of the blood gas analyzer. The patient's blood gas results will be ready within 60 seconds. Remove the syringe from the analyzer and reattach the filter cap. If you need to repeat the test D bubble and remix the sample prior to analysis. According to the CSI guidelines, blood gas testing should be completed within 10 minutes and not longer than 30 minutes after drawing the sample. Dispose of the syringe according to the hospital guidelines. Proper sample handling, mixing and time to analysis helps to ensure accurate patient results.

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