Available Stat

Yes

Performing Lab

Parnassus, Mission Bay and Mt Zion Chemistry

Methodology

Radiometer ABL 90 FLEX Plus
 

Additional Information

The following blood gas panels are available (click on the hyperlinks for detailed information about each component):

Cooximetry only (includes CAHB, O2HB, COHB, MEHB, O2HX)

LAB4441 (Arterial source)

LAB4442 (Venous source)

LAB4469 (Mixed Venous source)

LAB4458 (Central Venous source)

LAB5817 (CPCOOX): Capillary source or syringe

LAB4476 (Arterial Cord Blood source)

LAB4477 (Venous Cord Blood source)

 


Blood gas only (includes PH37, PCO2, PO2, BEX, HCO3, SAO2)

LAB 5818 (ABGO): Arterial source
LAB5819 (VBGO): Venous source
LAB5900 (CVBGO): Central venous source
LAB5901 (MVBGO): Mixed venous source
LAB5902 (CAPBGO): Capillary source
LAB5808 (CORBGA): Arterial cord blood source
LAB5809 (CORBGV): Venous cord blood source


Blood gas with Cooximetry (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, CAHB, O2HB, COHB, MEHB, O2HX)

LAB5820 (ABGCOX): Arterial source
LAB5821 (VBGCOX): Venous source

LAB5810 (CVBGCX): Central venous source

LAB5822 (MVBGCX): Mixed venous source

LAB4538: Capillary source

 

Blood gas with cooximetry and lactate (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, CAHB, O2HB, COHB, MEHB, O2HX, CAHB, NHCT, LACTWB) (includes hemoglobin and hematocrit)

LAB4422: Arterial source

LAB4423: Venous source

LAB4424: Central venous source

LAB4425: Mixed venous source

 

Blood Gas with lactate (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, NAWB, KSB, CAIB, CLWB, CAIB, GLB, CAHB, NHCT, LACTWB) (includes electrolytes (Na, K, Cl, iCa) and hemoglobin and hematocrit)

LAB5805 (ARTBGL): Arterial source
LAB5807 (VENBGL): Venous source
LAB5811 (CVBGL): Central venous source
LAB5813 (MVBGL): Mixed venous source
LAB5814 (CAPBG): Capillary source (Note: does NOT include lactate)


Circuit Blood Gas (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, NAWB, KSB, CAIB, CLWB, CAIB, CAHB, NHCT) (includes electrolytes (Na, K, Cl, iCA) and hemoglobin/hematocrit)


LAB5815 (CIRBGA): Arterial circuit source
LAB5816 (CIRBGV): Venous circuit source


 

Synonyms

  • CIRBGV
  • CIRBGA
  • MVBGCX
  • CAPBG
  • MVBGL
  • CVBGL
  • CVBGCX
  • VBGCOX
  • ABGCOX
  • CORBGV
  • CORBGA
  • CAPBGO
  • MVBGO
  • CVBGO
  • VBGO
  • ABGO
  • CPCOOX
  • ionized calcium
  • chloride
  • potassium
  • sodium
  • hematocrit
  • hemoglobin
  • hemoximetry, cooximetry
  • lactate
  • glucose
  • electrolytes
  • bicarbonate
  • carbon dioxide
  • oxygen
  • BE
  • BG
  • ABG
  • HCO3-
  • A-a gradient
  • Base excess
  • O2 Sat
  • O2 Saturation
  • pO2
  • pCO2
  • pH

Sample Type

Heparinized whole blood

Collect

Plastic blood gas syringe containing approximately 70 IU dry heparin in a 3 mL syringe or 23 IU in a 1 mL syringe -   or a  capillary tube coated with 70 IU heparin (Radiometer Clinitube).

Amount to Collect

3 mL blood

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Remarks

Arterial puncture:
Due to the risk of arterial damage and subsequent distal ischemia, prior to puncturing an artery the RN assesses the collateral circulation. If the radial artery is to be punctured, then the pulse of the ulnar artery is assessed. If the dorsalis pedis artery is to be accessed then the posterial tibial pulse is assessed and likewise if the posterial tibial approach is used the dorsalis pedis pulse is assessed. The modified Allens's test may be used to assess collateral circulation of the ulnar artery before a radial artery puncture, but it does not always ensure adequate flow. A Doppler ultrasound flow indicator may be used to verify collateral circulation. If the collateral circulation is poor and the RN cannot palpate a pulse then the physician should be notified before proceeding. If for any reason the circulation is compromised to the extremity being assessed for arterial puncture then the physician should be notified prior to proceeding.

1. Palpate the radial artery and identify the site where the pulse is the strongest. Avoid areas with overlying veins to prevent venous admixture.
2. Prepare the patient's skin with an alcohol or 2% chlorhexidine wipe/swab.
3. Place two or three fingers along the course of the artery both to locate its position and direction, and to stabilize it.
4. Penetrate the skin smoothly holding the needle at 30-60 degree angle with the needle bevel up and pointed proximally. The angle of the "butterfly" IV catheter should not exceed 45° for pediatric patients.
5. Re-establish the position and direction of the artery by palpation.
6. Gently and slowly advance the needle or "butterfly", aiming directly for the area of maximum pulsation.
7. When the arterial lumen has been entered, less resistance is felt and blood appears in the syringe above the needle hub.
8. Obtain required amount of arterial blood for test(s).
9. If blood is not obtained on first attempt, withdraw the needle to just below the skin surface and advance needle at same angle but at 1 mm to either side of previous attempt.
10. Place the 2x2 gauze over the site of the puncture then withdraw the needle from the artery. Press firmly at the site for at least five minutes, or until the bleeding stops. Apply bandage or pressure dressing.
11. Expel any air bubble in the syringe with air filter cap placed on specimen syringe.
12. Label sample with patient's name, ID number and DOB.

Venous samples:
1. Avoid excessive venous stasis from prolonged tourniquet application or clenching of the fist prior to sample collection.
2. For central line draws make sure to waste a full red top tube then draw via the blood gas syringe as noted above.
3. Fill syringe completely, remove needle (in peripheral draws), cap sample, expel all bubbles (while holding syringe upright) until blood hits the top of cap.
4. Label sample with patient's name, ID number and DOB.

Capillary Samples:
1. The following are recommended sampling sites: earlobe, finger tip, big toe, heel. The heel and big toe are more suitable for use on neonates and infants.
2. Warm the area or puncture site for 5 to 10 minutes prior to actual sampling. This accelerates flow for blood to be representative of general status of patient.
3. Make a puncture using a lancet or similar device. Do not squeeze the area to avoid tissue juice from mixing into blood sample.
4. Wipe off the first drop of blood. Take the sample from the center of the second drop of blood and hold the capillary at a slightly downward angle for an uninterrupted blood flow. Avoid getting air bubbles in the specimen.
5. Refrain from squeezing or milking the puncture site as this may result in faulty measurements or cause hemolysis of blood sample and cause elevated K+ readings.
6. Apply accompanying caps to both ends of the capillary tube and mix the sample with the heparin immediately after collection to prevent blood from clotting. The manufacturer recommends the use of a mixing wire and magnet for capillary samples.
7. Label sample with patient's name, ID and DOB.

Deliver samples immediately to lab for testing. Samples delivered to the lab > 30 minutes after collection may yield erroneous results.

Stability (from collection to initiation)

< 30 minutes

Test Code

See 'Additional Information' for relevant test codes.

Performing Lab

Parnassus, Mission Bay and Mt Zion Chemistry

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Stability (from collection to initiation)

< 30 minutes

Reference Interval

See separate entries for:

Blood gases

Cooximetry

Electrolytes

Glucose

Hematocrit

Lactate

Critical Values

See above hyperlinks

Additional Information

The following blood gas panels are available (click on the hyperlinks for detailed information about each component):

Cooximetry only (includes CAHB, O2HB, COHB, MEHB, O2HX)

LAB4441 (Arterial source)

LAB4442 (Venous source)

LAB4469 (Mixed Venous source)

LAB4458 (Central Venous source)

LAB5817 (CPCOOX): Capillary source or syringe

LAB4476 (Arterial Cord Blood source)

LAB4477 (Venous Cord Blood source)

 


Blood gas only (includes PH37, PCO2, PO2, BEX, HCO3, SAO2)

LAB 5818 (ABGO): Arterial source
LAB5819 (VBGO): Venous source
LAB5900 (CVBGO): Central venous source
LAB5901 (MVBGO): Mixed venous source
LAB5902 (CAPBGO): Capillary source
LAB5808 (CORBGA): Arterial cord blood source
LAB5809 (CORBGV): Venous cord blood source


Blood gas with Cooximetry (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, CAHB, O2HB, COHB, MEHB, O2HX)

LAB5820 (ABGCOX): Arterial source
LAB5821 (VBGCOX): Venous source

LAB5810 (CVBGCX): Central venous source

LAB5822 (MVBGCX): Mixed venous source

LAB4538: Capillary source

 

Blood gas with cooximetry and lactate (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, CAHB, O2HB, COHB, MEHB, O2HX, CAHB, NHCT, LACTWB) (includes hemoglobin and hematocrit)

LAB4422: Arterial source

LAB4423: Venous source

LAB4424: Central venous source

LAB4425: Mixed venous source

 

Blood Gas with lactate (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, NAWB, KSB, CAIB, CLWB, CAIB, GLB, CAHB, NHCT, LACTWB) (includes electrolytes (Na, K, Cl, iCa) and hemoglobin and hematocrit)

LAB5805 (ARTBGL): Arterial source
LAB5807 (VENBGL): Venous source
LAB5811 (CVBGL): Central venous source
LAB5813 (MVBGL): Mixed venous source
LAB5814 (CAPBG): Capillary source (Note: does NOT include lactate)


Circuit Blood Gas (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, NAWB, KSB, CAIB, CLWB, CAIB, CAHB, NHCT) (includes electrolytes (Na, K, Cl, iCA) and hemoglobin/hematocrit)


LAB5815 (CIRBGA): Arterial circuit source
LAB5816 (CIRBGV): Venous circuit source


 

Available Stat

Yes

Test Code

See 'Additional Information' for relevant test codes.

Performing Lab

Parnassus, Mission Bay and Mt Zion Chemistry

Methodology

Radiometer ABL 90 FLEX Plus
 

Remarks

Arterial puncture:
Due to the risk of arterial damage and subsequent distal ischemia, prior to puncturing an artery the RN assesses the collateral circulation. If the radial artery is to be punctured, then the pulse of the ulnar artery is assessed. If the dorsalis pedis artery is to be accessed then the posterial tibial pulse is assessed and likewise if the posterial tibial approach is used the dorsalis pedis pulse is assessed. The modified Allens's test may be used to assess collateral circulation of the ulnar artery before a radial artery puncture, but it does not always ensure adequate flow. A Doppler ultrasound flow indicator may be used to verify collateral circulation. If the collateral circulation is poor and the RN cannot palpate a pulse then the physician should be notified before proceeding. If for any reason the circulation is compromised to the extremity being assessed for arterial puncture then the physician should be notified prior to proceeding.

1. Palpate the radial artery and identify the site where the pulse is the strongest. Avoid areas with overlying veins to prevent venous admixture.
2. Prepare the patient's skin with an alcohol or 2% chlorhexidine wipe/swab.
3. Place two or three fingers along the course of the artery both to locate its position and direction, and to stabilize it.
4. Penetrate the skin smoothly holding the needle at 30-60 degree angle with the needle bevel up and pointed proximally. The angle of the "butterfly" IV catheter should not exceed 45° for pediatric patients.
5. Re-establish the position and direction of the artery by palpation.
6. Gently and slowly advance the needle or "butterfly", aiming directly for the area of maximum pulsation.
7. When the arterial lumen has been entered, less resistance is felt and blood appears in the syringe above the needle hub.
8. Obtain required amount of arterial blood for test(s).
9. If blood is not obtained on first attempt, withdraw the needle to just below the skin surface and advance needle at same angle but at 1 mm to either side of previous attempt.
10. Place the 2x2 gauze over the site of the puncture then withdraw the needle from the artery. Press firmly at the site for at least five minutes, or until the bleeding stops. Apply bandage or pressure dressing.
11. Expel any air bubble in the syringe with air filter cap placed on specimen syringe.
12. Label sample with patient's name, ID number and DOB.

Venous samples:
1. Avoid excessive venous stasis from prolonged tourniquet application or clenching of the fist prior to sample collection.
2. For central line draws make sure to waste a full red top tube then draw via the blood gas syringe as noted above.
3. Fill syringe completely, remove needle (in peripheral draws), cap sample, expel all bubbles (while holding syringe upright) until blood hits the top of cap.
4. Label sample with patient's name, ID number and DOB.

Capillary Samples:
1. The following are recommended sampling sites: earlobe, finger tip, big toe, heel. The heel and big toe are more suitable for use on neonates and infants.
2. Warm the area or puncture site for 5 to 10 minutes prior to actual sampling. This accelerates flow for blood to be representative of general status of patient.
3. Make a puncture using a lancet or similar device. Do not squeeze the area to avoid tissue juice from mixing into blood sample.
4. Wipe off the first drop of blood. Take the sample from the center of the second drop of blood and hold the capillary at a slightly downward angle for an uninterrupted blood flow. Avoid getting air bubbles in the specimen.
5. Refrain from squeezing or milking the puncture site as this may result in faulty measurements or cause hemolysis of blood sample and cause elevated K+ readings.
6. Apply accompanying caps to both ends of the capillary tube and mix the sample with the heparin immediately after collection to prevent blood from clotting. The manufacturer recommends the use of a mixing wire and magnet for capillary samples.
7. Label sample with patient's name, ID and DOB.

Deliver samples immediately to lab for testing. Samples delivered to the lab > 30 minutes after collection may yield erroneous results.

Collect

Plastic blood gas syringe containing approximately 70 IU dry heparin in a 3 mL syringe or 23 IU in a 1 mL syringe -   or a  capillary tube coated with 70 IU heparin (Radiometer Clinitube).

Amount to Collect

3 mL blood

Sample Type

Heparinized whole blood

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Reference Interval

See separate entries for:

Blood gases

Cooximetry

Electrolytes

Glucose

Hematocrit

Lactate

Critical Values

See above hyperlinks

Synonyms

  • pH
  • pCO2
  • pO2
  • O2 Saturation
  • O2 Sat
  • Base excess
  • A-a gradient
  • HCO3-
  • ABG
  • BG
  • BE
  • oxygen
  • carbon dioxide
  • bicarbonate
  • electrolytes
  • glucose
  • lactate
  • hemoximetry, cooximetry
  • hemoglobin
  • hematocrit
  • sodium
  • potassium
  • chloride
  • ionized calcium
  • CPCOOX
  • ABGO
  • VBGO
  • CVBGO
  • MVBGO
  • CAPBGO
  • CORBGA
  • CORBGV
  • ABGCOX
  • VBGCOX
  • CVBGCX
  • CVBGL
  • MVBGL
  • CAPBG
  • MVBGCX
  • CIRBGA
  • CIRBGV

Stability (from collection to initiation)

< 30 minutes

Additional Information

The following blood gas panels are available (click on the hyperlinks for detailed information about each component):

Cooximetry only (includes CAHB, O2HB, COHB, MEHB, O2HX)

LAB4441 (Arterial source)

LAB4442 (Venous source)

LAB4469 (Mixed Venous source)

LAB4458 (Central Venous source)

LAB5817 (CPCOOX): Capillary source or syringe

LAB4476 (Arterial Cord Blood source)

LAB4477 (Venous Cord Blood source)

 


Blood gas only (includes PH37, PCO2, PO2, BEX, HCO3, SAO2)

LAB 5818 (ABGO): Arterial source
LAB5819 (VBGO): Venous source
LAB5900 (CVBGO): Central venous source
LAB5901 (MVBGO): Mixed venous source
LAB5902 (CAPBGO): Capillary source
LAB5808 (CORBGA): Arterial cord blood source
LAB5809 (CORBGV): Venous cord blood source


Blood gas with Cooximetry (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, CAHB, O2HB, COHB, MEHB, O2HX)

LAB5820 (ABGCOX): Arterial source
LAB5821 (VBGCOX): Venous source

LAB5810 (CVBGCX): Central venous source

LAB5822 (MVBGCX): Mixed venous source

LAB4538: Capillary source

 

Blood gas with cooximetry and lactate (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, CAHB, O2HB, COHB, MEHB, O2HX, CAHB, NHCT, LACTWB) (includes hemoglobin and hematocrit)

LAB4422: Arterial source

LAB4423: Venous source

LAB4424: Central venous source

LAB4425: Mixed venous source

 

Blood Gas with lactate (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, NAWB, KSB, CAIB, CLWB, CAIB, GLB, CAHB, NHCT, LACTWB) (includes electrolytes (Na, K, Cl, iCa) and hemoglobin and hematocrit)

LAB5805 (ARTBGL): Arterial source
LAB5807 (VENBGL): Venous source
LAB5811 (CVBGL): Central venous source
LAB5813 (MVBGL): Mixed venous source
LAB5814 (CAPBG): Capillary source (Note: does NOT include lactate)


Circuit Blood Gas (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, NAWB, KSB, CAIB, CLWB, CAIB, CAHB, NHCT) (includes electrolytes (Na, K, Cl, iCA) and hemoglobin/hematocrit)


LAB5815 (CIRBGA): Arterial circuit source
LAB5816 (CIRBGV): Venous circuit source


 
Ordering

Available Stat

Yes

Performing Lab

Parnassus, Mission Bay and Mt Zion Chemistry

Methodology

Radiometer ABL 90 FLEX Plus
 

Additional Information

The following blood gas panels are available (click on the hyperlinks for detailed information about each component):

Cooximetry only (includes CAHB, O2HB, COHB, MEHB, O2HX)

LAB4441 (Arterial source)

LAB4442 (Venous source)

LAB4469 (Mixed Venous source)

LAB4458 (Central Venous source)

LAB5817 (CPCOOX): Capillary source or syringe

LAB4476 (Arterial Cord Blood source)

LAB4477 (Venous Cord Blood source)

 


Blood gas only (includes PH37, PCO2, PO2, BEX, HCO3, SAO2)

LAB 5818 (ABGO): Arterial source
LAB5819 (VBGO): Venous source
LAB5900 (CVBGO): Central venous source
LAB5901 (MVBGO): Mixed venous source
LAB5902 (CAPBGO): Capillary source
LAB5808 (CORBGA): Arterial cord blood source
LAB5809 (CORBGV): Venous cord blood source


Blood gas with Cooximetry (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, CAHB, O2HB, COHB, MEHB, O2HX)

LAB5820 (ABGCOX): Arterial source
LAB5821 (VBGCOX): Venous source

LAB5810 (CVBGCX): Central venous source

LAB5822 (MVBGCX): Mixed venous source

LAB4538: Capillary source

 

Blood gas with cooximetry and lactate (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, CAHB, O2HB, COHB, MEHB, O2HX, CAHB, NHCT, LACTWB) (includes hemoglobin and hematocrit)

LAB4422: Arterial source

LAB4423: Venous source

LAB4424: Central venous source

LAB4425: Mixed venous source

 

Blood Gas with lactate (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, NAWB, KSB, CAIB, CLWB, CAIB, GLB, CAHB, NHCT, LACTWB) (includes electrolytes (Na, K, Cl, iCa) and hemoglobin and hematocrit)

LAB5805 (ARTBGL): Arterial source
LAB5807 (VENBGL): Venous source
LAB5811 (CVBGL): Central venous source
LAB5813 (MVBGL): Mixed venous source
LAB5814 (CAPBG): Capillary source (Note: does NOT include lactate)


Circuit Blood Gas (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, NAWB, KSB, CAIB, CLWB, CAIB, CAHB, NHCT) (includes electrolytes (Na, K, Cl, iCA) and hemoglobin/hematocrit)


LAB5815 (CIRBGA): Arterial circuit source
LAB5816 (CIRBGV): Venous circuit source


 

Synonyms

  • CIRBGV
  • CIRBGA
  • MVBGCX
  • CAPBG
  • MVBGL
  • CVBGL
  • CVBGCX
  • VBGCOX
  • ABGCOX
  • CORBGV
  • CORBGA
  • CAPBGO
  • MVBGO
  • CVBGO
  • VBGO
  • ABGO
  • CPCOOX
  • ionized calcium
  • chloride
  • potassium
  • sodium
  • hematocrit
  • hemoglobin
  • hemoximetry, cooximetry
  • lactate
  • glucose
  • electrolytes
  • bicarbonate
  • carbon dioxide
  • oxygen
  • BE
  • BG
  • ABG
  • HCO3-
  • A-a gradient
  • Base excess
  • O2 Sat
  • O2 Saturation
  • pO2
  • pCO2
  • pH
Collection

Sample Type

Heparinized whole blood

Collect

Plastic blood gas syringe containing approximately 70 IU dry heparin in a 3 mL syringe or 23 IU in a 1 mL syringe -   or a  capillary tube coated with 70 IU heparin (Radiometer Clinitube).

Amount to Collect

3 mL blood

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Remarks

Arterial puncture:
Due to the risk of arterial damage and subsequent distal ischemia, prior to puncturing an artery the RN assesses the collateral circulation. If the radial artery is to be punctured, then the pulse of the ulnar artery is assessed. If the dorsalis pedis artery is to be accessed then the posterial tibial pulse is assessed and likewise if the posterial tibial approach is used the dorsalis pedis pulse is assessed. The modified Allens's test may be used to assess collateral circulation of the ulnar artery before a radial artery puncture, but it does not always ensure adequate flow. A Doppler ultrasound flow indicator may be used to verify collateral circulation. If the collateral circulation is poor and the RN cannot palpate a pulse then the physician should be notified before proceeding. If for any reason the circulation is compromised to the extremity being assessed for arterial puncture then the physician should be notified prior to proceeding.

1. Palpate the radial artery and identify the site where the pulse is the strongest. Avoid areas with overlying veins to prevent venous admixture.
2. Prepare the patient's skin with an alcohol or 2% chlorhexidine wipe/swab.
3. Place two or three fingers along the course of the artery both to locate its position and direction, and to stabilize it.
4. Penetrate the skin smoothly holding the needle at 30-60 degree angle with the needle bevel up and pointed proximally. The angle of the "butterfly" IV catheter should not exceed 45° for pediatric patients.
5. Re-establish the position and direction of the artery by palpation.
6. Gently and slowly advance the needle or "butterfly", aiming directly for the area of maximum pulsation.
7. When the arterial lumen has been entered, less resistance is felt and blood appears in the syringe above the needle hub.
8. Obtain required amount of arterial blood for test(s).
9. If blood is not obtained on first attempt, withdraw the needle to just below the skin surface and advance needle at same angle but at 1 mm to either side of previous attempt.
10. Place the 2x2 gauze over the site of the puncture then withdraw the needle from the artery. Press firmly at the site for at least five minutes, or until the bleeding stops. Apply bandage or pressure dressing.
11. Expel any air bubble in the syringe with air filter cap placed on specimen syringe.
12. Label sample with patient's name, ID number and DOB.

Venous samples:
1. Avoid excessive venous stasis from prolonged tourniquet application or clenching of the fist prior to sample collection.
2. For central line draws make sure to waste a full red top tube then draw via the blood gas syringe as noted above.
3. Fill syringe completely, remove needle (in peripheral draws), cap sample, expel all bubbles (while holding syringe upright) until blood hits the top of cap.
4. Label sample with patient's name, ID number and DOB.

Capillary Samples:
1. The following are recommended sampling sites: earlobe, finger tip, big toe, heel. The heel and big toe are more suitable for use on neonates and infants.
2. Warm the area or puncture site for 5 to 10 minutes prior to actual sampling. This accelerates flow for blood to be representative of general status of patient.
3. Make a puncture using a lancet or similar device. Do not squeeze the area to avoid tissue juice from mixing into blood sample.
4. Wipe off the first drop of blood. Take the sample from the center of the second drop of blood and hold the capillary at a slightly downward angle for an uninterrupted blood flow. Avoid getting air bubbles in the specimen.
5. Refrain from squeezing or milking the puncture site as this may result in faulty measurements or cause hemolysis of blood sample and cause elevated K+ readings.
6. Apply accompanying caps to both ends of the capillary tube and mix the sample with the heparin immediately after collection to prevent blood from clotting. The manufacturer recommends the use of a mixing wire and magnet for capillary samples.
7. Label sample with patient's name, ID and DOB.

Deliver samples immediately to lab for testing. Samples delivered to the lab > 30 minutes after collection may yield erroneous results.

Stability (from collection to initiation)

< 30 minutes
Processing

Test Code

See 'Additional Information' for relevant test codes.

Performing Lab

Parnassus, Mission Bay and Mt Zion Chemistry

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Stability (from collection to initiation)

< 30 minutes
Result Interpretation

Reference Interval

See separate entries for:

Blood gases

Cooximetry

Electrolytes

Glucose

Hematocrit

Lactate

Critical Values

See above hyperlinks

Additional Information

The following blood gas panels are available (click on the hyperlinks for detailed information about each component):

Cooximetry only (includes CAHB, O2HB, COHB, MEHB, O2HX)

LAB4441 (Arterial source)

LAB4442 (Venous source)

LAB4469 (Mixed Venous source)

LAB4458 (Central Venous source)

LAB5817 (CPCOOX): Capillary source or syringe

LAB4476 (Arterial Cord Blood source)

LAB4477 (Venous Cord Blood source)

 


Blood gas only (includes PH37, PCO2, PO2, BEX, HCO3, SAO2)

LAB 5818 (ABGO): Arterial source
LAB5819 (VBGO): Venous source
LAB5900 (CVBGO): Central venous source
LAB5901 (MVBGO): Mixed venous source
LAB5902 (CAPBGO): Capillary source
LAB5808 (CORBGA): Arterial cord blood source
LAB5809 (CORBGV): Venous cord blood source


Blood gas with Cooximetry (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, CAHB, O2HB, COHB, MEHB, O2HX)

LAB5820 (ABGCOX): Arterial source
LAB5821 (VBGCOX): Venous source

LAB5810 (CVBGCX): Central venous source

LAB5822 (MVBGCX): Mixed venous source

LAB4538: Capillary source

 

Blood gas with cooximetry and lactate (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, CAHB, O2HB, COHB, MEHB, O2HX, CAHB, NHCT, LACTWB) (includes hemoglobin and hematocrit)

LAB4422: Arterial source

LAB4423: Venous source

LAB4424: Central venous source

LAB4425: Mixed venous source

 

Blood Gas with lactate (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, NAWB, KSB, CAIB, CLWB, CAIB, GLB, CAHB, NHCT, LACTWB) (includes electrolytes (Na, K, Cl, iCa) and hemoglobin and hematocrit)

LAB5805 (ARTBGL): Arterial source
LAB5807 (VENBGL): Venous source
LAB5811 (CVBGL): Central venous source
LAB5813 (MVBGL): Mixed venous source
LAB5814 (CAPBG): Capillary source (Note: does NOT include lactate)


Circuit Blood Gas (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, NAWB, KSB, CAIB, CLWB, CAIB, CAHB, NHCT) (includes electrolytes (Na, K, Cl, iCA) and hemoglobin/hematocrit)


LAB5815 (CIRBGA): Arterial circuit source
LAB5816 (CIRBGV): Venous circuit source


 
Administrative
Complete View

Available Stat

Yes

Test Code

See 'Additional Information' for relevant test codes.

Performing Lab

Parnassus, Mission Bay and Mt Zion Chemistry

Methodology

Radiometer ABL 90 FLEX Plus
 

Remarks

Arterial puncture:
Due to the risk of arterial damage and subsequent distal ischemia, prior to puncturing an artery the RN assesses the collateral circulation. If the radial artery is to be punctured, then the pulse of the ulnar artery is assessed. If the dorsalis pedis artery is to be accessed then the posterial tibial pulse is assessed and likewise if the posterial tibial approach is used the dorsalis pedis pulse is assessed. The modified Allens's test may be used to assess collateral circulation of the ulnar artery before a radial artery puncture, but it does not always ensure adequate flow. A Doppler ultrasound flow indicator may be used to verify collateral circulation. If the collateral circulation is poor and the RN cannot palpate a pulse then the physician should be notified before proceeding. If for any reason the circulation is compromised to the extremity being assessed for arterial puncture then the physician should be notified prior to proceeding.

1. Palpate the radial artery and identify the site where the pulse is the strongest. Avoid areas with overlying veins to prevent venous admixture.
2. Prepare the patient's skin with an alcohol or 2% chlorhexidine wipe/swab.
3. Place two or three fingers along the course of the artery both to locate its position and direction, and to stabilize it.
4. Penetrate the skin smoothly holding the needle at 30-60 degree angle with the needle bevel up and pointed proximally. The angle of the "butterfly" IV catheter should not exceed 45° for pediatric patients.
5. Re-establish the position and direction of the artery by palpation.
6. Gently and slowly advance the needle or "butterfly", aiming directly for the area of maximum pulsation.
7. When the arterial lumen has been entered, less resistance is felt and blood appears in the syringe above the needle hub.
8. Obtain required amount of arterial blood for test(s).
9. If blood is not obtained on first attempt, withdraw the needle to just below the skin surface and advance needle at same angle but at 1 mm to either side of previous attempt.
10. Place the 2x2 gauze over the site of the puncture then withdraw the needle from the artery. Press firmly at the site for at least five minutes, or until the bleeding stops. Apply bandage or pressure dressing.
11. Expel any air bubble in the syringe with air filter cap placed on specimen syringe.
12. Label sample with patient's name, ID number and DOB.

Venous samples:
1. Avoid excessive venous stasis from prolonged tourniquet application or clenching of the fist prior to sample collection.
2. For central line draws make sure to waste a full red top tube then draw via the blood gas syringe as noted above.
3. Fill syringe completely, remove needle (in peripheral draws), cap sample, expel all bubbles (while holding syringe upright) until blood hits the top of cap.
4. Label sample with patient's name, ID number and DOB.

Capillary Samples:
1. The following are recommended sampling sites: earlobe, finger tip, big toe, heel. The heel and big toe are more suitable for use on neonates and infants.
2. Warm the area or puncture site for 5 to 10 minutes prior to actual sampling. This accelerates flow for blood to be representative of general status of patient.
3. Make a puncture using a lancet or similar device. Do not squeeze the area to avoid tissue juice from mixing into blood sample.
4. Wipe off the first drop of blood. Take the sample from the center of the second drop of blood and hold the capillary at a slightly downward angle for an uninterrupted blood flow. Avoid getting air bubbles in the specimen.
5. Refrain from squeezing or milking the puncture site as this may result in faulty measurements or cause hemolysis of blood sample and cause elevated K+ readings.
6. Apply accompanying caps to both ends of the capillary tube and mix the sample with the heparin immediately after collection to prevent blood from clotting. The manufacturer recommends the use of a mixing wire and magnet for capillary samples.
7. Label sample with patient's name, ID and DOB.

Deliver samples immediately to lab for testing. Samples delivered to the lab > 30 minutes after collection may yield erroneous results.

Collect

Plastic blood gas syringe containing approximately 70 IU dry heparin in a 3 mL syringe or 23 IU in a 1 mL syringe -   or a  capillary tube coated with 70 IU heparin (Radiometer Clinitube).

Amount to Collect

3 mL blood

Sample Type

Heparinized whole blood

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Reference Interval

See separate entries for:

Blood gases

Cooximetry

Electrolytes

Glucose

Hematocrit

Lactate

Critical Values

See above hyperlinks

Synonyms

  • pH
  • pCO2
  • pO2
  • O2 Saturation
  • O2 Sat
  • Base excess
  • A-a gradient
  • HCO3-
  • ABG
  • BG
  • BE
  • oxygen
  • carbon dioxide
  • bicarbonate
  • electrolytes
  • glucose
  • lactate
  • hemoximetry, cooximetry
  • hemoglobin
  • hematocrit
  • sodium
  • potassium
  • chloride
  • ionized calcium
  • CPCOOX
  • ABGO
  • VBGO
  • CVBGO
  • MVBGO
  • CAPBGO
  • CORBGA
  • CORBGV
  • ABGCOX
  • VBGCOX
  • CVBGCX
  • CVBGL
  • MVBGL
  • CAPBG
  • MVBGCX
  • CIRBGA
  • CIRBGV

Stability (from collection to initiation)

< 30 minutes

Additional Information

The following blood gas panels are available (click on the hyperlinks for detailed information about each component):

Cooximetry only (includes CAHB, O2HB, COHB, MEHB, O2HX)

LAB4441 (Arterial source)

LAB4442 (Venous source)

LAB4469 (Mixed Venous source)

LAB4458 (Central Venous source)

LAB5817 (CPCOOX): Capillary source or syringe

LAB4476 (Arterial Cord Blood source)

LAB4477 (Venous Cord Blood source)

 


Blood gas only (includes PH37, PCO2, PO2, BEX, HCO3, SAO2)

LAB 5818 (ABGO): Arterial source
LAB5819 (VBGO): Venous source
LAB5900 (CVBGO): Central venous source
LAB5901 (MVBGO): Mixed venous source
LAB5902 (CAPBGO): Capillary source
LAB5808 (CORBGA): Arterial cord blood source
LAB5809 (CORBGV): Venous cord blood source


Blood gas with Cooximetry (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, CAHB, O2HB, COHB, MEHB, O2HX)

LAB5820 (ABGCOX): Arterial source
LAB5821 (VBGCOX): Venous source

LAB5810 (CVBGCX): Central venous source

LAB5822 (MVBGCX): Mixed venous source

LAB4538: Capillary source

 

Blood gas with cooximetry and lactate (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, CAHB, O2HB, COHB, MEHB, O2HX, CAHB, NHCT, LACTWB) (includes hemoglobin and hematocrit)

LAB4422: Arterial source

LAB4423: Venous source

LAB4424: Central venous source

LAB4425: Mixed venous source

 

Blood Gas with lactate (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, NAWB, KSB, CAIB, CLWB, CAIB, GLB, CAHB, NHCT, LACTWB) (includes electrolytes (Na, K, Cl, iCa) and hemoglobin and hematocrit)

LAB5805 (ARTBGL): Arterial source
LAB5807 (VENBGL): Venous source
LAB5811 (CVBGL): Central venous source
LAB5813 (MVBGL): Mixed venous source
LAB5814 (CAPBG): Capillary source (Note: does NOT include lactate)


Circuit Blood Gas (includes PH37, PCO2, PO2, BEX, HCO3, SAO2, NAWB, KSB, CAIB, CLWB, CAIB, CAHB, NHCT) (includes electrolytes (Na, K, Cl, iCA) and hemoglobin/hematocrit)


LAB5815 (CIRBGA): Arterial circuit source
LAB5816 (CIRBGV): Venous circuit source


 

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