Our Full Guide on ABGs 👉 —————
How to Stick an ABG?
An ABG test requires collecting a small sample of blood from an artery. The sample must be obtained by either the Respiratory Therapist, doctor, or a qualified technician.
First and foremost, before sticking the patient, you must determine the best site for collecting the blood sample.
Here are the possible ABG Sample Sites:
-- Wrist (radial artery)
-- Upper arm (brachial artery)
-- Groin (femoral artery)
In addition, a blood sample can also be obtained in a pre-existing arterial line.
An ABG blood sample cannot be obtained from a vein, as this would instead be a VBG, or venous blood gas.
Once the site is determined, the Respiratory Therapist will then sterilize the injection site using an antiseptic or antimicrobial solution.
The radial artery is the preferred site to stick an ABG because has good collateral circulation and it is superficial and easy to palpate. Also, it’s not near any large veins, and the stick is relatively pain-free.
The patient will be positioned either lying down or sitting with the arm well supported.
You may use a rolled towel positioned under the patient’s wrist in order to provide comfort for the patient and to hyperextend the site of injection. This position makes it easier to palpate the pulse and stick the artery.
After the radial artery is located, the Respiratory Therapist will then insert a sterile needle into the artery to draw blood.
In some cases, the syringe needs to be repositioned in order to locate and puncture the artery. When doing this, you will withdraw the tip of the syringe to the subcutaneous tissue to prevent severing the artery or tendons and avoiding damage to the nearby tissues.
It’s also extremely painful for the patient if you’re digging around in their wrist with the needle while trying to hit the artery. This is something I see a lot with students and new Respiratory Therapists.
Not to worry. You’ll get better at sticking the arteries with more practice and experience.
Once the blood sample is obtained, a sterile gauze and bandage will be placed over the punctured wound in order to stop bleeding and avoid infection.
The blood sample will be immediately sent to the laboratory for analysis. The specimen must be analyzed within 15 minutes after extraction in order to ensure accurate ABG results are obtained.
It is important to keep in mind that an ABG stick may be difficult to perform in uncooperative patients, those with hard-to-find pulses, patients with cognitive impairment, patients with tremors, and those with a significant amount of body fat.
In some cases, multiple attempts are needed in order to draw the sample.
However, repeated puncture of a single site increases the prevalence of a hematoma, which is swelling of clotted blood within the tissues, and also scarring.
In severe cases, it can also cut the artery and cause a significant amount of bleeding. So you may need to use alternate sites in order to draw the blood sample if too many unsuccessful attempts are made in the same spot.
Again collecting these blood sample can be quite challenging for some Respiratory Therapists.
But as I always say, practice makes perfect; and the more you do it, the easier it gets and the better you become at sticking ABGs.
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💡DISCLAIMER
Medicine and Respiratory Therapy are continuously changing practices. The information in this video is for educational and entertainment purposes only. For medical advice, please consult with a physician or qualified medical professional.
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