Arterial sticks protocols

Would anyone be willing to share their units protocols for arterial sticks. We are trying to put together a new protocol so that our nurses can be certified for arterial sticks.

Thanks,

I work NICU, not PICU, but we also do arterial sticks...

Once a nurse finishes her orientation, she takes a written test that covers IVs and lab draws after reading an information packet about them. For IV sticks, heel sticks, and arterial punctures, she must observe experienced nurses doing the procudures and then is allowed to try on her own with another nurse observing her. After three successful sticks, she is signed off on each of the skills and then can do them on her own. The written test and signed off skills sheet are put into the employee's file.

We also we must do an Allen test before all radial arterial punctures. We also only do arterial sticks if necessary - if we need to obtain blood cultures or if the amount of blood we need is too much to obtain by heelstick.

Hope this helps a bit.

At our hospital, only RT's are allowed to perform art sticks. Even if there is just an order for art sticks for labs or blood cultures.

thank you for your replies. What I am looking for is protocols that other institutions use to ceritfy the RN in art sticks. In our hospitals RT do not do art sticks only RN or MD's. so I was hoping to see what other hospitals use as a check off list.

We do a yearly competency, take a test and then get checked off. RT does most of them, but I've started doing some if they need repeat chem's, etc..

1. I work in NY state is there a law that states that RT's are the only ones that do arterial sticks. I know of some hospitals that nurses do arterial sticks. I was wondering if this is just a Hospital policy or in fact any Nurse can do artial ABG's with proper training of course. I came from another state where the nurses obtianed the ABG's.

2: The RT's also put in arteial lines and some even suture these lines, this seems beyond their scope of practice. Any thoughts about the legality of this as well.

Ive never worked or heard of anything as ridiculous as RTs putting in Alines, thats just crazy. Im not sure about their scope of practice, but it seems wrong to me...

I find that very interesting, Ive worked in 4 diff states, 6 hospitals and never heard of or saw such at thing. What state is this where, putting in A-lines is done by RTs?

It baffles me that there are states that do not allow nurses to do art sticks. One of the states I work in has the same rule and I cant stand burning up veins to get blood for cx's and large amounts of blood, like during an admission (the docs arent there for admits, so no lines placed for blood.) It can be time consuming and an added pain for the baby when you have to make multiple attempts for blood. It is insane that a nurse can not stick art sites. We can put in UVC's in an emergency, but cant poke a artery???

Sorry, had to rant!!!

PS, in the other state I work in RT's do art sticks, but not art lines. However, we have residents/fellows/neo's available around the clock, so there is no reason for RT's/RN's to do art lines.

RTs draw blood gases if the patient has no line....nurses do not. RTs do not start the A- line...only the docs do that.

I work in a PICU where RNs are allowed to do art sticks. I also know the NICU nurses do this. However, a general peds RN is not allowed. Unfortunately, there was no formal training in this area. This was treated just like PIV starts and blood draws: gaining experience w/practice.