Blood Gas Sample Collection and Proper Handling: Venous Blood Gas Sample Draw

This is an instructional video about how to collect the venous blood gas sample. And the proper handling of the sample immediately after obtaining the blood and justice prior to performing the blood gas analysis, follow your local hospital procedures to prepare the patient and collection site for obtaining the blood sample. Arterial blood may be difficult to obtain due to a patient's diminished pulse rate or low blood pressure, whereby a venous blood collection represents a viable option. Venous samples for blood gas analysis may be obtained from a peripheral vein by vena puncture or, particularly for patients in the intensive care unit, from a central venous catheter or from the distal port of a pulmonary artery catheter, which is referred to as a mixed venous sample. Typically, the antecubital veins are the common draw site for vena puncture. Draw the sample slowly, within less than one minute of applying the tourniquet. Peripheral venous sample is suitable to determine the acid base balance of a patient and to monitor the acid base balance trends or to screen for systemic acidosis. In addition, electrolytes, metabolites, hemoglobin, and the disc hemoglobin variants may be reported on a venous sample. However, venous oxygen values may be different from the arterial blood oxygenation status. Many patients in the intensive care unit have a central venous catheter, from which venous blood can be easily obtained for testing. Attention should be taken and reported as to the site of the catheter placement, such as a jugular, subclavian line, a pick or femoral line. The oxygen exchange in the various regions of the body can lead to extreme differences of the values. This information is critical and AIDS the clinician in the interpretation of the results when it comes to mixed venous sample analysis. Blood is collected from an indwelling catheter in the pulmonary artery, typically referred to as a swan Ganz catheter. The blood obtained from the pulmonary artery catheter is used for the dynamic diagnostic evaluation and management of the critically ill patients. When mixed venous blood gases from the pulmonary artery are combined with arterial blood gas measurements, the results frequently clarify the cardio pulmonary status and assist in determining appropriate therapeutic procedures to be initiated. The blood gas analysis is performed to test vitals and critically ill patients. Blood gas testing gives information on pH, the gases, the electrolytes, metabolites, total hemoglobin, Co oximetry and neonatal total bilirubin. Ensure you have all the materials you need to draw the patient sample. Depending on the type of venous sample, drawn materials may include a heparinized syringe with a filter cap. A central line kit or pulmonary artery catheter kit, a saline flush syringe in empty waste syringe to clear the CVC line, alcohol or decontaminant wipe and dressing, just to name a few of the items. The syringe used for blood gas analysis should include dry electrolyte, balanced lithium heparin as the preferred anticoagulant in a concentration of approximately 23 international units per milliliter of. Blood. Before obtaining the venous sample, confirm the patient's identity. Follow your hospital directives for the proper protocol when obtaining a blood gas sample by vena puncture or from either a central line or a pulmonary artery catheter. Clean the venous blood draw site or the central line cannula port. Let it dry. Do not use a cleaning wipe that contains quaternary ammonium substance such as benzalkonium, as it may affect the electrolyte parameters reported, particularly sodium. Perform a saline flush. And attach the waist syringe. And remove the initial fluid from the central line or the pulmonary artery catheter. The amount of fluid that needs to be withdrawn varies with the line system used. Remove and discard the waste syringe. Attach the heparinized syringe to the line cannula port and slowly withdraw the desired volume of blood from the patient. Once the desired amount of blood is obtained without bubbles or frothing, remove the syringe from the line cannula. Attach the filter cap on the lure tip of the syringe. And hold the syringe vertically. And gently tap the syringe so that air bubbles are forced to the top. Expel any air bubbles into the filter cap. Mix the sample thoroughly by rotating your wrist back and forth for a minimum of 20 seconds. This helps to dissolve the heparin and minimize clot formation in the syringe. Label the syringe with the patient ID. And immediately transport the sample to a Siemens healthineers blood gas system. Follow a 2 step mixing process first by rotating your wrist back and forth. And then rolling the syringe between your hands about 10 times. Remove the cap from the syringe and expel the first few drops of blood into a gauze pad. Present the sample to the analyzer and start analysis. Recognize that a sample containing blood clots should not be used on the blood gas analyzer because it can affect not only the accuracy of the patient results, but also negatively impact the operation of the blood gas analyzer. The patient's blood gas results will be ready within 60 seconds. Remove the syringe from the analyzer. Reattach the filter, cap in de, bubble the sample. If you need to repeat the test, remix the sample prior to analysis. According to the CLSI guidelines, blood gas testing should be completed within 10 minutes and not longer than 30 minutes after drawing the sample. If testing is delayed longer than 30 minutes, samples should be placed in an ice slurry and will require additional mixing prior to analysis dispose of the syringe, according to the hospital guideline. Proper sample handling, mixing and time to analysis helps to ensure accurate patient results.

2.0 0.5 1.0 1.5 2.5 20 3.0 50 10 45 15- 40 35 30 25 00106262018001 12 BL Blood Gas Sample Collection and Proper Handling Venous Blood Gas Sample Draw tion Venous Sampling for Blood Gas Testing Follow your local hospital procedures to prepare the patient and collection site for obtaining the blood sample. Venous Blood Gas (VBG) Is an alternative sample type to arterial blood collection Peripheral Venous Sample Central Venous Catheter Sample Mixed Venous CONTAINS HEPARIN NOT FOR INJECTION Peripheral venous sample collection by venipuncture CONTAINS HEPARIN NOT FOR INJECTION Release tourniquet immediately after blood begins to flow (especially when measuring hemoglobin and lactate). Apply pressure to the draw site. pH pCo2 Follow hospital protocol for pO2 collected on venous samples. Electrolytes Metabolites Hemoglobin Venous po2 Central Venous Catheter (CVC) Internal Jugular (IJ) Subclavian Line (SC) Peripherally Inserted Central Catheter (PICC) Femoral Venous Site Pulmonary Artery Catheter (PAC) for mixed venous sampling SIEMENS Mixed venous sample results Arterial blood gas results Blood Gas Analysis Gases Total hemoglobin CO-oximetry Neonatal bilirubin Heparinized syringe Filter cap Follow hospital procedures PAC Kit Saline syringe Waste syringe Alcohol wipes MOIST TOWELETTE TTE Gauze Bandage Heparin concentration of 23 I.U. / mL blood FIRTH Lamar B. DOB: 05/20/1981 Patient ID Clean the patient draw site Let it dry MOIST TOWELETTE Cleansing LATEX FREE Premoistened Cleansing Toweletter Single Use Only QTY Benzalkonium Chloride TOW LETTE Ber Cleansing Tow Ben Saline flush 10mL Remove initial waste fluid 10ml in Pull back on the syringe plunger to collect desired blood volume Maintain sample integrity - No bubbles - No frothing Attach filter cap and hold vertically Tap gently to remove air bubbles Expel air bubbles into filter cap Mix sample in figure 8 motion 55 60 5 30 25 55 60 20 seconds Lamar B Label the syringe with patient ID Roll syringe between hands Expel blood into gauze pad Present the syringe to the analyzer SIEMENS . WARNING: Clots can affect the accuracy of the test results and the fluidics of the instrument. Healthineers 1 Touch to view the video if you need help. Replace the sample port. - 45 60 seconds Remove 10 minutes Dispose syringe Proper sample handling, mixing and time to analysis helps to ensure accurate patient results. Siemens Healthcare Diagnostics Inc ., 2023 RAPIDLab, RAPIDPoint and all associated marks are trademarks of Siemens Healthcare Diagnostics Inc ., or its affiliates. Product availability may vary from country to country and is subject to varying regulatory requirements. Please contact your local representative for availability.