Procedural Skills for Medical Students
Arterial Blood Draw, ABG sampling, and Percutaneous Arterial Line Cannulation
Objectives:
1. Learners should be able to verbalize the
indications and contraindications for arterial
blood draw and peripheral arterial line
placement.
2. Learners should be able to identify and
describe the test for assessing ulnar
collateral circulation (Modified Allen Test).
3. Learners should verbalize possible postprocedure complications.
Material to review prior to lab: Video on Arterial Puncture and Arterial Line Placement (need
access to New England Journal of Medicine, available to students through the University of
Arizona Health Sciences Library)
Indications:
1. To assess an arterial blood sample on a patient in respiratory distress or a patient with a
chronic condition or impaired gas exchange (COPD).
2. To confirm hypoxia and/or hypercapnia.
3. To obtain arterial blood for certain laboratory tests (i.e. lactate, ammonia,
carboxyhemoglobin, methemoglobin, or carbon monoxide levels).
Contraindications:
1.
2.
3.
4.
A functional arterial line is present.
Overlying skin compromised by trauma, burn, infection or severe dermatitis.
Previous surgery on the site (possible scarring).
Inability to palpate arterial pulse or poor collateral circulation (positive Modified Allen
test).
Equipment: HPS, arterial vascular access trainer, 20g radial arterial catheterization sets, serum
lab collection tubes.
Instructional Procedure & Endpoints:
1. Learners will be oriented to trainer and equipment in ASTEC.
2. ASTEC staff will demonstrate proper technique for arterial blood draw and
percutaneous arterial line placement.
3. ASTEC staff will discuss placement of blood into appropriate sample tubes.
4. Learners will demonstrate Modified Allen test on each other.
5. Learners will demonstrate one successful arterial blood draw from arterial vascular
access trainer prior to completion of lab.
1
Procedural Skills for Medical Students
References:
Dev, S.P, Hillmer, M.D., & Ferri, M. (2011). Arterial puncture for blood gas analysis. The New
England Journal of Medicine, 354(e7). Retrieved from
http://www.nejm.org/doi/full/10.1056/NEJMvcm0803851#figure=vcm0803851_t
humb111x111.jpg
Fowler, G.C. & Landen, D.A. (2011). Arterial puncture and percutaneous arterial line
placement. In J.L. Pfenninger, & G.C. Fowler (Eds.), Procedures for Primary Care, 3rd
Ed (1421-1431). Philadelphia: Elsevier Mosby.
Tegtmeyer, K., Brady, G., Lai, S., Hodo, R., & Braner, D. (2006). Placement of an arterial line.
The New England Journal of Medicine, 354(e7). Retrieved from
http://www.nejm.org/doi/full/10.1056/NEJMvcm044149#figure=preview.gif
2