• Collection of arterial blood for blood gas analysis
to manage cardiopulmonary disorders and maintain acid-base balance.
• Collection of arterial blood when unable to sample venous blood
to help manage fluid and electrolyte imbalance.
• Coagulation abnormalities, such as hypercoagulability
• Patient has disease associated with hypercoagulability or hypocoagulability.
• Hematoma at site.
• Anatomic abnormalities in limb.
• 23-gauge or smaller butterfly needle.
• 1-mL heparinized syringe for blood gas sampling.
• Syringes for blood sampling.
• Disinfectant (povidone-iodine, chlorhexidine, and alcohol) swabs.
• Sterile gauze pads.
• Topical anesthetic.
• Use smallest gauge needle to minimize arterial
• Hold pressure over puncture to prevent hematoma formation and
• The radial artery and the femoral artery are the preferred sites
for arterial puncture.
• If the pulse is hard to palpate, use Doppler and mark the location.
• In small infants, the radial artery may be located by transillumination.
• The Allen test involves the following:
• Localizing and assessing the radial pulse.
• Encircling the patient’s wrist with your hand and elevating
• Applying occlusive pressure on the radial and the ulnar arteries.
• Releasing the ulnar artery and continuing to apply occlusive
pressure on the radial artery.
• Monitoring palmar blush.
• Introduce yourself to the patient and parents.
• Explain the procedure to the patient (if appropriate) and the
• Choose site of puncture.
• Apply topical anesthetic to the site.
• Position the patient with the puncture site within
• Have an assistant gently immobilize the extremity.
• If using the femoral artery, open the femoral joint by elevating
it over a rolled up towel.
• The radial artery is located at the wrist proximal
to the head of the radius.
• In most patients, collateral circulation is dependent on an intact
Anatomy of radial artery.
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