Phlebotomy Ch.13: Lecture 2
Artery Puncture
- Label and ice specimen
make sure to dispose of needle in the sharps container
label specimen with waterproof pen and place in ice slurry and deliver to the lab immed.
Complications
Arteriospasm
constriction of artery due to pain, preventing O2 from reaching tissue
nerve damage
caused by accidental contact with a nerve
Hematoma
caused by going through the artery or holding inadequate pressure
Thrombosis
clot formation within artery
Hemorrhage
can occur in pts receiving anticoagulantion therapy
infection
can occur from skin contamination and be carried to rest of the body
Sampling Errors
they must be chilled if not analyzed within 30 minutes to prevent gas loss
using too much heparin lowers pH
using too little heparin can cause clotting
inadequate mixing can cause clotting
air bubbles decrease CO2 values
improper syringe causes gas loss
pH alters with use of incorrect anticoagulant
puncturing a vein instead of an artery
contamination with room air after collection
Specimen Rejection
specimen quantity is not sufficient
specimen is clotted
improper or no label
use a wrong syringe
air bubbles in the specimen
failure to chill if not testing within 30 minutes
specimen is delayed too long to be tested
Capillary blood gases
alternative to ABG's especially in pediatric pts
not as desirable b/c capillary blood is a mixture of venous blood, arterial blood and tissue fluid
collection technique also allows for exposure to room air before sealing
CBG procedure
use normal heel stick procedure except warm for 5-10 minutes to make blood more arterialized
use heparinized capillary tube; some may require a metal flea to be inserted prior to collection
fill completely with blood and seal ends
mix contents using the magnet and flea
transport chilled until analyzed