II. Indications
III. Sites of sampling
- Radial artery
- Other sites (higher risk of neurovascular injury)
- Brachial artery
- Femoral artery
IV. Technique: Preparation for Radial Artery Puncture
- Perform Allen Test to confirm collateral circulation
- Heparinize syringe
- Clean radial entry site
- Povidone-Iodine solution (Betadine)
- Alcohol swab
- Consider Local Anesthetic at entry site
- Small skin wheal of Lidocaine 1%
V. Technique: Obtaining Radial Artery Sample
- Needle entry
- Identify radial artery with gentle pressure
- Patient dorsiflexes wrist
- Needle and syringe angled 45 degrees toward arm
- Enter skin just distal to palpated artery site
- Slowly advance needle until spontaneous blood enters
- Arterial Blood Collection
- Hold needle steady until 1-2 cc blood obtained
- Allow syringe to fill itself (avoid aspirating)
- If flow ceases
- Slowly withdraw needle 1-2 mm
- Repositions needle back inside arterial lumen
VI. Technique: Completing Sample Collection
- Withdrawing needle
- Withdraw needle from skin
- Immediately apply pressure over entry site
- Hold pressure at entry site for 5 minutes
- Sample preparation for lab
- Express any air bubbles from syringe
- Cork needle or remove needle and cap syringe
- Roll syringe between fingers to mix Heparinize sample
- Immediately place sample on ice
- Label Sample
- Patient identification data
- Sample acquisition time
- FIO2 at time of sample draw
- Patient's Body Temperature
- Deliver sample quickly to the lab
VII. Complications
- Nerve Injury
- Ischemic changes hand and wrist
- Always check Allen Test before radial artery puncture
- Occult bleeding
- Especially at brachial and femoral artery punctures