ABG's

OK...here's my question this week.... What's your policy on drawing ABGs from UACs.... Have any of you heard that using alcohol before drawing up could cause a change in values? So are you supposed to draw back a few ccs then get your abg sample, then put the removed blood back, and then alcohol and cap off? I'm sorry to ask you guys this! IT's just that I ask a million questions at work... and I feel like I should know the answer to this one! Thanks!!!

Our policy is to prep the port with betadine or persist (betadine/alcohol swab). It's important to let the betadine dry so I usually prep first and then gather my supplies. I clear the line with approximately 1 cc (for an ABG ... more for a chemistry or coags). After drawing the gas, and making sure I have not contaminated the clear, I give it back. I then clean the blood off the port with alcohol. Some nurses draw back less and waste the clear, but I prefer to do it this way because a heparin- contaminated gas is useless. If you're ever surprised by an incredibly acidotic gas result with PCo2 in the teens and a significant base deficit, it may be heparin-contaminated.

Even if the alcohol is dry?

In my unit, we don't prep the port at all--neither alcohol nor betadine. We just draw back 1-2 mLs of hep/blood and then draw our ABG sample. However, our RTs do a great deal of sampling from those lines as well. I just keep the line sterile and don't let it touch anything. That's how I was taught, though. As usual, however, there are always errors in practice and I've witnessed them. On the other hand, we do not have a lot of infected UACs or PALs. Guess it kinda varies everywhere with different schools of thought.

[NicuGal, MSN, RN]

Betadine, alcohol and then draw. Same for central line draws.

I have a question NCIUJOE...do you prep your IIP's/HL's and IV ports before giving meds? Or do you not have a rubber stopper on the end of the port? We aren't allowed to leave syringes on ours, we always have a port stopper.

We draw back 1ml, draw our sample(s), give back the first draw and flush with 0.5cc hep saline. If drawing coags it is 3 ml draw and then the coags and then give it back.