Healthcare and Medicine Reference
In-Depth Information
(a)
(b)
(c)
Figure 6.1 Allen's test. (a) The patient's hand is elevated and pressure
applied to both the radial and ulnar arteries. (b) The patient's hand will
blanch white. (c) On release of pressure over the ulnar artery the hand
should re-perfuse and lose its white colouration.
Table 6.1 The points of access for arterial sample.
Lateral thoracic
Advantages
Disadvantages
Thoracoacromial
artery
Radial
Lies close to the surface
Easily compressible
Easy aseptic approach
End artery
Pulse may be hard to feel
in shut down patients or in
patients with atrial fi brillation
Subscapular
Brachial
Can lie close to the surface
Easy aseptic approach
Easily compressible
End artery, quite mobile!
Close proximity to the nerve
Axillary nerve
Circumflex scapular
Profunda brachii
Femoral
Reliable position, good
landmarks
Can take other bloods at the
same time
Can be found in shut down
patients with poor or no pulses
Dirtier' area of the body
May dislodge plaque in PVD
Median nerve
Radial
nerve
The brachial artery (Figure 6.3) lies 0.5-1.5 cm deep, medial to
the biceps tendon, with the median nerve running along its medial
edge.
The femoral artery (Figure 6.4) is the deepest, at between 2-4 cm,
and is found at the mid-inguinal point 2 cm below the inguinal
ligament. The femoral nerve lies laterally and the vein medially.
Common interosseous
Posterior interosseous
Equipment: types of blood gas syringe
There are several types on the market and different organisations
will stock different brands. The following features are present.
Blood gas syringes contain heparin to prevent clotting of the blood
Radial nerve
Radial artery
Ulnar
nerve
Anterior interosseous
Ulnar
artery
(and ultimately prevent clogging of the analyser!). The heparin
can be in two forms: (i) liquid; which must be expelled (leaving a
thin fi lm on the inner surface of the syringe) before procedure; or
(ii) an impregnated patch in the base of the syringe.
Some gas syringes will come in a pack with a needle, bung and
Flexor carpi radialis
cap; others will only have a cap.
Most syringes are designed to self-fi ll; those that do not require
Figure 6.2 Anatomy of the radial artery. (From Faiz O, Moffat D. (2006)
Anatomy at a Glance , 2nd edn. Blackwell Publishing, Oxford, with
permission.)
traction on the plunger.
 
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