Term
| Indications for arterial puncture |
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Definition
-assess level of dissolved gases
-acute dysfunction in CO2/O@ exchange (e.g. asthma, pulm thromboembolism, idiopathic coma, suspected drug OD, shock states, cardiac arrhythmias refractory to meds, monitoring of patient with severe CO2/O@ exchange or acid-base imbalance, COPD, pts on LT oxygen, after therapeutic hyperventilation therapy, or cardiopulm resuscitation, quantify pts response to therapeutic interventions, and severe hypovolemia is present and venous sample can't be obtained
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Term
| Labs that req arterial blood samples |
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Definition
| ammonia levels (liver failure), CO levels, lactate levels |
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Term
| contraindications for arterial puncture |
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Definition
negative Allen test
no visible landmarks
Pts with coagulopathy, severe thrombocytopenia, anticoagulant therapy, end-stage renal dz, local skin infxns, chronic rashes, and previously burned/scarred skin, Coumadin pts |
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Term
| complications of arterial puncture |
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Definition
hemorrhage or hematoma at puncture site
thrombosis (lead to ischemia and gangrene)
transient arterial spasm
nerve damage |
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Term
| Possible locations of arterial puncture |
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Definition
Radial (Best)
Brachial
Femoral (good for cardiac arrest)
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Term
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Definition
| special heparinized syringe, ice for transport, arm board |
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Term
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Definition
-insert 1-2 cc of EPI
-perform on pt's non-dominant hand
-locate point of maximal pulsation
-face the pt
-hold syringe like a dart
-insert need at 40-60 degree angle (60-90 angle for femoral)
-collect 3-5 cc of blood
-apply pressure dressing
-send to lab on ice STAT |
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