ATS Pulmonary Function Laboratory Manual

chapter  15

3.

Femoral artery 3.1.

Large vessel that is easily palpated and punctured (1).

3.2. Generally, this is the last site selected in clinical practice because of poor collateral circulation to the leg, and increased chance of infection if the site is not thoroughly cleansed (1). 4. Age limits for the performance of arterial punctures versus capillary samples should be defined by each medical director. Hazards/Complications of Arterial Puncture (1) 1. Vasovagal response, which can result in a loss of consciousness. If patient has fainted or is unexpectedly nonresponsive you should: 1.1. Notify the designated first-aid-trained personnel. 1.2. Where practical, lay the patient flat or lower his/her head and arms (if sitting) and loosen tight clothing. 2. Arteriospasm 2.1. A reflex constriction of the artery in response to pain or other stimuli. 2.2. May make it impossible to obtain blood even though needle is properly located in the lumen. 3. Hematoma 4. Thrombosis and embolism 4.1. Most likely to happen if a needle or cannula is left in place for some time.

Procedure (1, 4)

Pre-Test Preparation

Step Action 1. Check patient identification. Ask the patient to state or spell his/her first and last names, and date of birth. Verify the spelling and date of birth against ID band, and/or requisition. IF THEN Patient unable to provide information • Get information from family member or caregiver, if present. • Notify person in charge, if a family member or caregiver is not present to provide the information.

The identifiers do not match

• Contact registration. • Resolve discrepancies before proceeding. • Do not proceed. • Notify patient’s nurse or registration desk.

The ID band is present but not attached to the patient Check for a complete physician’s order.

2.

3. Collect and record demographic information, verify clinical indication for arterial sampling, verify ventilatory status, Fi O2 , and delivery system. 4. Explain the specimen collection procedure and have patient seated or lying comfortably.

173