ABG
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| Primary purpose of obtaining ABG samples | 1. adequacy of oxygenation 2. adequacy of ventilation 3. reflects lung formation
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| 3 major hazards of arterial puncture | 1. bleeding 2. obstruction of vessel. 3. infection
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| 3 major criteria for selection of arterial puncture site | 1. collateral blood flow 2. vessel accessibitly 3. peripheral structures
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| Collateral blood flow | If it's part of a colatoral circulation system it can prevent loss of distal blood flow in the event of arterial obstruction
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| Vessel accessbility | the best vessel for puncture is one that is easy to palpate, relatively superficial and somewhat stable
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| Peripheral structures | the best site for arterial punctures are those whcih do not have extremely sensitive adjacent structures such as nerves
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| The order of preference that sites usually utilize for arterial puncture | radial, bronchial, femoral
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| Allen test | elevate hand and make fist for 20 secs, firm pressure held against radial and ulnar arteries, pt opens hand should blanch white, examiner releases only ulnar compression
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| alternative methods of assessing for collateral circulation | doppler ultrasound, and pulse oximetry
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| Correct procedure for obtaining ABG | hold syringe @45 for radial, tell pt "going to feel stick", enter needle quickly, withdraw 1-2 ml, press gauze on site for 3-5 min, check for bubbles, seal syringe while holding site pressure (roll syringe)
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| Appropriate action to preserve the sample awaiting analyzation | put syringe in ice
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| What should be written on lab slip | date, time, pt name, O2 %, temp if abnormal, your initials
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| Factors that would necessitate holding pressure greater than 5 minutes from arterial puncture | pt using anticoagulants, and low platelet counts
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