right arterial puncture is required to obtain arterial blood. For analysis of ph and blood gas values in trauma victims or patients with cardiopulmonary abnormality, three sites are available for obtaining arterial blood. The radio artery. Break your artery and femoral artery. The radio artery is preferred since it is easily accessible and it's puncture causes few complications. The radio artery and nerve pass along the radio side of the forearm from the elbow to the wrist. The site for puncture is at the distal portion of the radius because it is close to the surface centers away from any major nerves. The break your artery must be used when radio pulses are faint when approaching the break your artery in the anti cubicle fossa. Care must be taken to avoid the owner and radial nerves. The femoral artery should be used only when the other sites are unavailable, such as with severe trauma or when it is the only detectable pulse. The site for a femoral artery puncture is in the femoral triangle. The artery lies in between the femoral vein and nerve and can easily be detected by palpitating a sartorius muscle and the inguinal ligament and stepping off from either of these two points into the triangle. Great care must be taken to avoid damaging either the vein or the nerve. Either a three or five millimeter glass or plastic syringe. With lure lock is used. Glass syringes are easier to handle because the plunger moves more freely in the barrel, making it easier to detect pulsating arterial blood, the plastic syringes more available. Less expensive and offers reliable results If the blood sample is analyzed quickly to avoid diffusion through the plastic. Other equipment for arterial puncture includes alcohol swabs for prepping the skin, sodium heparin for coating the barrel and plunger. Come on A 23 or 20 five gauge needle. Gauze patches, rubber hub, which is placed on the lure lock and a basin of ice. An arterial blood gas sample pack contain the necessary equipment can also be used before the puncture, prepare the glass or plastic syringe by wetting the barrel with Approximately .25 CCS of heparin. Do not draw air into the syringe and inject it into the heparin bottle. This procedure may alter the results of the blood gas analysis, gently pull and rotate the plunger back until the barrel is coated and eject the remaining solution. It is not necessary to leave Heparin in either the glass or plastic syringe to carry out radio artery puncture, extend the wrist, palm up a small towel may be placed under the risk to aid an extension. Next Locate a point for puncture approximately two cm proximal to the second wrist. Crease palpate the skin to locate the pulse. It is important to palpate across the risk to locate the area of strongest pulse. Follow the artery along its route to help visualize the anatomy. Prep the area with alcohol and relocate the artery with a single palpitating finger holding the syringe like a pencil, advance The needle at an approximately 45 degree angle Bevel up. If there is difficulty in obtaining the sample, you may have to advance the needle further as the artery maybe deeper than expected, or rotate the syringes the bevel of the needle maybe against the wall of the artery. If the artery has rolled to the side, withdraw the needle slightly and advance it when using a glass syringe with a freely moving plunger entry into the artery will result in automatic filling of the syringe by way of the arterial blood pressure with a plastic syringe, the blood will have to be aspirated because a small gauge needle will cause slow filling into the barrel. Aspiration of even the glass syringe may be necessary to collect the sample. The following live sequence will show a radio artery puncture in a clinical setting. To inject a small amount of pain. The patient should first be given an explanation of the procedure to make the patient more comfortable. A local anesthetic such as 1% Zilla cane can be used locate the artery and inject zilla, Kane, subcutaneous lee in this area. Following an alcohol prep. Yeah. Okay. A little stick pull back on the needle to make sure you are not in the vein before injecting the solution. Right A glass syringes prepared by placing a number 23 or 25 gauge needle on the lure lock and drawing in a small amount of heparin to coat the barrel and plunger prep the wrist and relocate the artery. Hold the bowel of the syringe like a pencil with a needle bevel up with a quick smooth motion entered the skin at approximately a 40 five degree angle, gradually advance the needle until you enter the lumen of the artery. Okay, allow a small amount of blood to enter the syringe. The pulse, little movement of the blood will assure you that you have entered the artery, stabilize the needle and pull back gently on the plunger to help fill the syringe 222 and one half milliliters of blood is adequate for analysis. Be ready with your free hand to compress the artery with a dry gauze square as you withdraw the needle, we move the needle from the lure lock, making sure that there are no air bubbles in the sample and place a rubber lure tip cap on the syringe. Place the sample in ice, apply pressure on the Artery until all surface bleeding has stopped. This is usually 3-5 minutes. A plastic syringe may be used to collect the sample when no glass syringes available. Greater care must be taken in locating the artery by palpitation since the barrel of the syringe will not move freely in response to arterial blood prep the selected area and enter the skin. Yeah. Okay, mm hmm. Mhm. Pull back gently on the plunger to collect the sample preparation for lab analysis is the same as with the glass syringe, a lot of people will break through the scanner. Okay. Yeah. Okay well hold on. In cases of severe trauma, the femoral artery may be the only site where a pulse can be found because of the close proximity of the vein and nerve is important to locate the artery and bracketed between the forefinger and middle finger. The needle is then positioned between the fingers. Use a glass syringe and hold it at a more nearly right angle than for a radio puncture. The following scene shows ephemeral puncture in a trauma situation following palpitation and location of the artery prepped the area with alcohol. Hold the needle at a more nearly right angle than for a radio puncture and aim it into the clearly felt pulse. Following the collection of the sample. The syringe is sealed and iced because of the larger size of this artery, it is necessary to apply pressure for a greater length of time, usually five to 10 minutes. In summary the steps of the procedure are prepare the syringe by wetting the bow with heparin, palpate the area to locate the artery prepped the area with alcohol. Hold the syringe like a pencil at a 45° angle and advance the needle slowly until you enter the artery observed pulsar tile blood in the hub of the needle or in the syringe stabilize the needle and pull back gently on the plunger. Okay compress the artery. Following withdrawal of the needle, remove any air bubbles and seal the syringe. Place the sample on ice, continue compression of the artery until all surface bleeding has stopped.