Skill Checklists for Taylor's Clinical Nursing Skills: A Nursing Process Approach

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Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:

SKILL 18-11

Obtaining an Arterial Blood Specimen for

Blood Gas Analysis (Continued)

Comments

9.Perform Allen’s test before obtaining a specimen from the

radial artery:

a. Have the patient clench the wrist to minimize blood

flow into the hand.

b. Using your index and middle fingers, press on the radial

and ulnar arteries. Hold this position for a few seconds.

c. Without removing your fingers from the arteries, ask

the patient to unclench the fist and hold the hand in a

relaxed position. The palm will be blanched because

pressure from your fingers has impaired the normal

blood flow.

d. Release pressure on the ulnar artery. If the hand

becomes flushed, which indicates that blood is filling

the vessels, it is safe to proceed with the radial artery

puncture. This is considered a positive test. If the hand

does not flush, perform the test on the other arm.

10. Put on unsterile gloves. Locate the radial artery and lightly
    palpate it for a strong pulse.


11. Clean the site with the antimicrobial swab. If using
    chlorhexidine, use a back-and-forth motion, applying fric-
    tion for 30 seconds to the site, or use the procedure recom-
    mended by the manufacturer. Allow the site to dry. After
    disinfection, do not palpate the site unless sterile gloves
    are worn.


12. Stabilize the hand with the wrist extended over the rolled
    towel, palm up. Palpate the artery above the puncture site
    with the index and middle fingers of your nondominant
    hand while holding the syringe over the puncture site with
    your dominant hand. Do not directly touch the area to be
    punctured.


13. Hold the needle bevel up at a 45-degree angle at the site of
    maximal pulse impulse, with the shaft parallel to the path
    of the artery. (When puncturing the brachial artery, hold
    the needle at a 60-degree angle.)


14. Puncture the skin and arterial wall in one motion. Watch
    for blood backflow in the syringe. The pulsating blood will
    flow into the syringe. Do not pull back on the plunger. Fill
    the syringe to the 5-mL mark.

ExcellentSatisfactoryNeeds Practice

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