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Arterial Blood Gas

Procedure (ABG)
By: Reymond E. Bicariato, RN
Objectives:
By the end of this session students will:
1. Understand ABG and its terms?
2. Know some of the indications and
contraindications for performing an
arterial puncture.
3. Be able to demonstrate the technique
for performing an arterial puncture.
What is an ABG
 Arterial Blood Gas
 Drawn from artery- radial, brachial, femoral
 It is an invasive procedure.
 Caution must be taken with patient on
anticoagulants.
 Helps differentiate oxygen deficiencies from
primary ventilatory deficiencies from primary
metabolic acid-baseabnormalities.
Common terms:
 PCO2 Partial pressure CO2
 PO2 Partial pressure O2
 HCO3 Bicarbonate
 BE Base excess
 SaO2 Oxygen Saturation
Normal ABG values
 pH 7.35 – 7.45
 PCO2 35 – 45 mmHg
 PO2 80 – 100 mmHg
 HCO3 22 – 26 mmol/L
 BE -2 - +2
 SaO2 >95%
Information Obtained from an ABG:
 Acid base status
 Oxygenation
 Dissolved O2 (pO2)
 Saturation of hemoglobin
 CO2 elimination
 Levels of carboxyhemoglobin and
methemoglobin
Indications:
 Assess the ventilatory status, oxygenation and
acid base status.
 Assess the response to an intervention.
Contraindications:
 Bleeding diathesis
 AV fistula
 Severe peripheral vascular disease, absence of an
arterial pulse
 Infection over site
Complications:

The most common complication from an


arterial puncture is hematoma at the site. Less
common but important complications are
thrombus in the artery and infection at the
site.
Allen test for collateral flow:
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.
Preparing to perform the Procedure:
 Make sure you and the patient are comfortable.
 Assess the patency of the radial and ulnar
arteries
Equipment:

Prior to performing an arterial puncture all the


necessary equipment should be ready at the bedside.
Equipment includes:
 Gloves
 Heparinized arterial blood gas syringe kit
 Alcohol swabs
 2x2 gauze
 Tape
 Patient label (put on syringe prior to putting in ice
bag)
 Bag of ice for transport to lab
Heparinized arterial blood gas
syringe kit
Performing the Procedure:
 Put on gloves
 Prepare the site
 Drape the bed
 Cleanse the radial area with a alcohol
 Position the wrist (hyper-extended, using a rolled up
towel if necessary)
 Palpate the arterial pulse and visualize the course of
the artery.
 If you are going to use local anesthetic, infiltrate the
skin with 2% xylocaine.
 Open the ABG kit
Performing the Procedure (cont.)
 Line the needle up with the artery, bevel side
up.
 Enter the artery and allow the syringe to fill
spontaneously.
 Withdraw the needle and hold pressure on the
site.
 Protect needle
 Remove any air bubbles
 Gently mix the specimen by rolling it between
your palms
 Place the specimen on ice and transport to lab
immediately.
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.
The End

THANK YOU
VERY MUCH!!!!!