Goal: A specimen is obtained without compromise to the patency of the arterial line.
1. Verify the order for laboratory testing on the patient’s medical record.
2. Gather all equipment and bring to bedside.
3. Perform hand hygiene and put on PPE, if indicated.
4. Identify the patient.
5. Close curtains around bed and close the door to the room, if possible. Explain the procedure to the patient.
6. Compare specimen label with patient identification bracelet. Label should include patient’s name and identification number, time specimen was collected, route of collection, identification of the person obtaining sample, and any other information required by agency policy.
7. Put on gloves and goggles or face shield.
8. Turn off or temporarily silence the arterial pressure alarms, depending on facility policy.
9. Locate the stopcock nearest the arterial line insertion site. Use the alcohol swab or chlorhexidine to scrub the sampling port on the stopcock. Allow to air dry.
10. Attach a 5-mL syringe into the sampling port on the stopcock to obtain the discard volume. Turn off the stopcock to the flush solution. Aspirate slowly until blood enters the syringe. Stop aspirating. Note the volume in the syringe, which is the dead-space volume. Continue to aspirate until the dead-space volume has been withdrawn a total of three times. For example, if the dead-space volume is 0.8 mL, aspirate 2.4 mL of blood.
11. Turn the stopcock to the halfway position between the flush solution and the sampling port to close the system in all directions.
12. Remove the discard syringe and dispose of appropriately.
13. Place the syringe for the laboratory sample or the Vacutainer in the sampling port of the stopcock. Turn the stopcock off to the flush solution, and slowly withdraw the required amount of blood. For each additional sample required, repeat this procedure. If coagulation tests are included in the required tests, obtain blood for this from the final sample.
14. Turn the stopcock to the halfway position between the flush solution and the sampling port to close the system in all directions. Remove the syringe or Vacutainer. Apply the rubber cap to the ABG syringe hub, if necessary. 15. Insert a 5-mL syringe into the sampling port of the stopcock. Turn off the stopcock to the patient. Activate the in-line flushing device. Flush through the sampling port into the syringe to clear the stopcock and sampling port of any residual blood.
16. Turn off the stopcock to the sampling port; remove the syringe. Remove sampling port cap and replace with new sterile one. Intermittently flush the arterial catheter with the in-line flushing device until the tubing is clear of blood.
17. Remove gloves. Reactivate the monitor alarms. Record date and time the samples were obtained on the labels, as well as the required information to identify the person obtaining the samples. If ABG was collected, record oxygen flow rate (or room air) on label. Apply labels to the specimens, according to facility policy. Place in biohazard bags; place ABG sample in bag with ice.
18. Check the monitor for return of the arterial waveform and pressure reading.
19. Return the patient to a comfortable position. Lower bed height, if necessary, and adjust head of bed to a comfortable position.
20. Remove goggles and additional PPE, if used. Perform hand hygiene. Send specimens to the laboratory immediately.
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