Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content + • 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. ++ Absolute + • Allen test indicates that collateral circulation is compromised.• Circulatory defects.• Sampling area is infected. ++ Relative + • Coagulation abnormalities, such as hypercoagulability or hypocoagulability.• Patient has disease associated with hypercoagulability or hypocoagulability.• Hematoma at site.• Anatomic abnormalities in limb. ++Table Graphic Jump LocationFavorite Table | Download (.pdf) | Print• Caution: All equipment must be latex free. + • Gloves.• 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. + • Ischemia.• Hematoma. + • Use smallest gauge needle to minimize arterial trauma.• Hold pressure over puncture to prevent hematoma formation and bleeding.• 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 the hand.• 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 parents.• Choose site of puncture.• Apply topical anesthetic to the site. + • Position the patient with the puncture site within easy reach.• Have an assistant gently immobilize the extremity.• If using the femoral artery, open the femoral joint by elevating it over a rolled up towel. ++ Radial Artery + • The palmar arch is composed of the radial and ulnar arteries and connecting palmar arteries (Figure 11–1). + • 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 ulnar artery. ++Figure 11–1.Graphic Jump LocationView Full Size|Favorite Figure|Download Slide (.ppt)Anatomy of radial artery. ++ Femoral Artery + • The femoral artery is located below the inguinal ligament over the femoral gutter halfway between the pubic symphysis and the anterior superior iliac spine (Figure 11–2). + • The femoral artery lies in the gutter lateral to the femoral vein. ++Figure 11–2.Graphic Jump LocationView Full Size|Favorite Figure|Download Slide (.ppt)... GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessPediatrics 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessPediatrics Full Site: One-Year Individual Subscription $595 USD Buy Now View All Subscription Options