ATS Pulmonary Function Laboratory Manual

chapter  15

Procedure Notes 1.

Safety and infection control 1.1. Standard precautions (SP) are followed when collecting blood specimens (8–10). 1.1.1.

Barrier protection must be used to prevent contamination with body fluids to which SP apply. This means gloves must be worn for an arterial puncture. Eye covering or face shield should be worn, if there is likelihood for splattering.

1.2. Hands or other skin surfaces should be washed immediately, if contaminated with blood (1). 1.3. Unintentional injuries caused by needles must be immediately reported (1). 1.4. Workers with exudative lesions or weeping dermatitis should refrain from patient contact (1). 1.5. Proper blood collection techniques must be used. 1.6. Adhere to current Occupational Safety and Health Administration (OSHA) guidelines at all times. 1.7. Dispose of needles, syringes, and blood specimens in puncture-resistant containers (2). 1.8. Workers should receive the Hepatitis B vaccine, or sign a waiver refusing to do so. 2. The use of local anesthesia is optional. If used, 1% lidocaine without epinephrine is recommended (1). References 1. Clinical and Laboratory Standards Institute. Procedures for the collection of arterial blood speci- mens: approved standard, 4th ed. Clinical and Laboratory Standards Institute; 2010. H11–A4,24(28). 2. Knowles TP, Mullin RA, Hunter JA, Douce FH. Effects of syringe material, sample storage time, and temperature on blood gases and oxygen saturation in arterialized human blood samples. Respir Care 2006;51:732–736. 3. Raffin TA. Indications for arterial blood gas analysis. Ann Intern Med 1986;105:390–398. 4. Greenhow DE. Incorrect performance of Allen’s test—ulnar-artery folow erroneously presumed in­ adeguate. Anesthesiology 1972;37:356–357. 5. Allen EV. Thromboangitis obliterans: methods of diagnosis of chronic occlusive arterial lesions distal to the wrist with illustrative cases. Am J Med Sci 1929;178:237–244. 6. Shapiro BA, Peruzzi WT, Kozelowski-Templin R. Obtaining blood gas samples. Chapter 25 in: Clinical application of blood gases, 5th ed. St. Louis, MO: Mosby-Year Book, Inc.; 1994. pp. 301–312. 7. Hansen JE, Simmons DH. A systematic error in the determination of blood Pco 2 . Am Rev Respir Dis 1977;115:1061–1063. 8. Siegel JD, Rhinehart E, Jackson M, Chiarello L, and the Healthcare Infection Control Practices Ad- visory Committee. 2007 Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings. Available from: http://www.cdc.gov/ncidod/dhqp/pdf/isolation2007.pdf 9. Department of Labor, Occupational Safety and Health Administration. Occupational exposure to blood born pathogens . 29 CFR Part 1910.1030. 2001. 10. Clinical and Laboratory Standards Institute. M29–A4E Protection of laboratory workers from occu- pationally acquired infection: approved guideline, 4th ed. 2014.

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