Ordering Recommendations

Follow the link for information about Blood Gas Panels that contain this test.

Available Stat

Yes

Performing Lab

Parnassus, Mission Bay and Mt Zion Chemistry

Performed

Test available 24 hours per day 7 days per week

Methodology

Radiometer ABL 90 FLEX Plus
 

Reported

STAT: 10 min

Additional Information

Glycolic acid, the ethylene glycol metabolite, causes erroneously high results in this assay.

Synonyms

  • Lactic acid
  • ARTBGL
  • VENBGL
  • CVBGL
  • MVBGL
  • Blood gas
  • ABG

Sample Type

Heparinized whole blood (Blood gas syringe only)

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.


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

Unacceptable Conditions

Samples submitted > 30 min after collection, samples with needle attached, containing large bubbles, unlabeled, clotted or of insufficient volume.

Test Code

NLACT (battery code)
LACTWB (test code)

LAB4445: Arterial source

LAB4446: Venous source

LAB4447: Central venous source

LAB4448: Mixed venous source

Test Group

Lactate

Performing Lab

Parnassus, Mission Bay and Mt Zion Chemistry

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Unacceptable Conditions

Samples submitted > 30 min after collection, samples with needle attached, containing large bubbles, unlabeled, clotted or of insufficient volume.

Units

mmol/L

Reference Interval

Arterial, mixed venous, central venous and capillary: 0.5-2.0 mmol/L

Venous: 0.5-2.2 mmol/L

Cord blood umbilical artery:1.9 – 10.2 mmol/L

Cord blood umbilical vein: 1.7 – 8.9 mmol/L

Critical Values

> 3.9 mmol/L (does not apply to cord blood sample sources)

Additional Information

Glycolic acid, the ethylene glycol metabolite, causes erroneously high results in this assay.

Available Stat

Yes

Ordering Recommendations

Follow the link for information about Blood Gas Panels that contain this test.

Test Code

NLACT (battery code)
LACTWB (test code)

LAB4445: Arterial source

LAB4446: Venous source

LAB4447: Central venous source

LAB4448: Mixed venous source

Test Group

Lactate

Performing Lab

Parnassus, Mission Bay and Mt Zion Chemistry

Performed

Test available 24 hours per day 7 days per week

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.


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 (Blood gas syringe only)

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Unacceptable Conditions

Samples submitted > 30 min after collection, samples with needle attached, containing large bubbles, unlabeled, clotted or of insufficient volume.

Units

mmol/L

Reference Interval

Arterial, mixed venous, central venous and capillary: 0.5-2.0 mmol/L

Venous: 0.5-2.2 mmol/L

Cord blood umbilical artery:1.9 – 10.2 mmol/L

Cord blood umbilical vein: 1.7 – 8.9 mmol/L

Critical Values

> 3.9 mmol/L (does not apply to cord blood sample sources)

Synonyms

  • Lactic acid
  • ARTBGL
  • VENBGL
  • CVBGL
  • MVBGL
  • Blood gas
  • ABG

Reported

STAT: 10 min

Additional Information

Glycolic acid, the ethylene glycol metabolite, causes erroneously high results in this assay.
Ordering

Ordering Recommendations

Follow the link for information about Blood Gas Panels that contain this test.

Available Stat

Yes

Performing Lab

Parnassus, Mission Bay and Mt Zion Chemistry

Performed

Test available 24 hours per day 7 days per week

Methodology

Radiometer ABL 90 FLEX Plus
 

Reported

STAT: 10 min

Additional Information

Glycolic acid, the ethylene glycol metabolite, causes erroneously high results in this assay.

Synonyms

  • Lactic acid
  • ARTBGL
  • VENBGL
  • CVBGL
  • MVBGL
  • Blood gas
  • ABG
Collection

Sample Type

Heparinized whole blood (Blood gas syringe only)

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.


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

Unacceptable Conditions

Samples submitted > 30 min after collection, samples with needle attached, containing large bubbles, unlabeled, clotted or of insufficient volume.
Processing

Test Code

NLACT (battery code)
LACTWB (test code)

LAB4445: Arterial source

LAB4446: Venous source

LAB4447: Central venous source

LAB4448: Mixed venous source

Test Group

Lactate

Performing Lab

Parnassus, Mission Bay and Mt Zion Chemistry

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Unacceptable Conditions

Samples submitted > 30 min after collection, samples with needle attached, containing large bubbles, unlabeled, clotted or of insufficient volume.
Result Interpretation

Units

mmol/L

Reference Interval

Arterial, mixed venous, central venous and capillary: 0.5-2.0 mmol/L

Venous: 0.5-2.2 mmol/L

Cord blood umbilical artery:1.9 – 10.2 mmol/L

Cord blood umbilical vein: 1.7 – 8.9 mmol/L

Critical Values

> 3.9 mmol/L (does not apply to cord blood sample sources)

Additional Information

Glycolic acid, the ethylene glycol metabolite, causes erroneously high results in this assay.
Administrative
Complete View

Available Stat

Yes

Ordering Recommendations

Follow the link for information about Blood Gas Panels that contain this test.

Test Code

NLACT (battery code)
LACTWB (test code)

LAB4445: Arterial source

LAB4446: Venous source

LAB4447: Central venous source

LAB4448: Mixed venous source

Test Group

Lactate

Performing Lab

Parnassus, Mission Bay and Mt Zion Chemistry

Performed

Test available 24 hours per day 7 days per week

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.


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 (Blood gas syringe only)

Preferred Volume

3 mL blood

Minimum Volume

1 mL blood

Unacceptable Conditions

Samples submitted > 30 min after collection, samples with needle attached, containing large bubbles, unlabeled, clotted or of insufficient volume.

Units

mmol/L

Reference Interval

Arterial, mixed venous, central venous and capillary: 0.5-2.0 mmol/L

Venous: 0.5-2.2 mmol/L

Cord blood umbilical artery:1.9 – 10.2 mmol/L

Cord blood umbilical vein: 1.7 – 8.9 mmol/L

Critical Values

> 3.9 mmol/L (does not apply to cord blood sample sources)

Synonyms

  • Lactic acid
  • ARTBGL
  • VENBGL
  • CVBGL
  • MVBGL
  • Blood gas
  • ABG

Reported

STAT: 10 min

Additional Information

Glycolic acid, the ethylene glycol metabolite, causes erroneously high results in this assay.

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