12. ARTERIAL BLOOD GAS SAMPLING

Published on 21/06/2015 by admin

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Last modified 21/06/2015

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CHAPTER 12. ARTERIAL BLOOD GAS SAMPLING
Indications105
Contraindications106
Equipment107
Practical procedure107
Femoral artery puncture109
Complications109
Gustav Magnus (1802–1870) made the first consistent analyses of blood gases in 1837. He obtained his blood samples from both horses and ‘commoners who for a small sum permitted themselves to be bled’. Magnus went on to estimate the oxygen capacity of blood in 1845. However, modern blood gas analysis is the accumulation of the work of numerous brilliant men, namely Cremer (1865–1935), Haber (1868–1934), Hasselbalch (1874–1962), Van Slyke (1883–1971), Henderson (1878–1942), Astrup (1915–2000), Clark (1918–2005) and Severinghaus (1922–). These men pioneered the construction and refinement of the hydrogen, oxygen and carbon dioxide electrodes. Furthermore, they also constructed formulae to explain the relationships between the directly measured values of haemoglobin, oxygen tension, acidity and carbon dioxide, and the derived calculations of base deficit and bicarbonate.

INTRODUCTION

Arterial blood gas sampling provides useful information in the assessment of both respiratory function and acid–base balance. The usual site of puncture is the radial artery, although femoral and brachial arteries are common alternatives when the radial approach proves to be difficult. It is important to understand the anatomy of vessels in the area (Fig. 12.1) prior to puncture to ensure successful sampling, and to minimize discomfort and complications to the patient.

INDICATIONS

• Measurement of blood oxygen tension.
• Measurement of blood carbon dioxide tension.
• Measurement of acidaemia/alkalaemia (pH).
• Measurement of bicarbonate and base excess.

CONTRAINDICATIONS

• Local infection around predicted puncture site
• Lack of consent.
• Negative Allen’s test.

ALLEN’S TEST

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