How to Perform Femoral Artery Punctures

An arterial blood gas (ABG) draw is used to analyze the oxygen, carbon dioxide, bicarbonate and pH levels of arterial blood, giving the doctor invaluable information concerning a patient’s status. Typically drawn from the radial artery in the wrist or the brachial artery at the crook of the elbow, ABGs may also be taken from the femoral artery if the patient has poor circulation in the upper extremities.

Things You'll Need

• Latex gloves
• Alcohol swab
• Povidone-iodine swab
• Self-filling heparinized blood gas syringe with cap
• Short beveled needle, 20 to 22 gauge
• Sterile 4x4 gauze
• Label containing patient name, hospital number, date, time and respiratory modality

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Instructions

• 1

  Don latex gloves. Never perform a blood draw without wearing gloves.

• 2

  Use the alcohol swabs in a circular motion from the center outward to clean the puncture sight. Then wipe the site again with povidone-iodine swabs to sterilize the area.

• 3

  If you are right handed, use the left hand to locate a femoral pulse. When the pulse is found, demarcate the area with your index and middle fingers.

• 4

  Inspect the self-filling heparinized blood gas syringe; make sure that the plunger is around the 2-cc mark. Add the short beveled needle if it is not already attached, and remove the cap; lay it on a tray or countertop nearby.

• 5

  Use the fingers of your left hand as a guide to “feel your way” to the artery. Slip the needle carefully between your fingers, and insert it until it begins to fill. If the hub meets the patient’s thigh without filling, withdraw the needle carefully about three-quarters of the way, reposition and try again until it begins to fill, and then stop advancing the needle. As the syringe fills, remove your left hand from the puncture site to avoid needlesticks.

• 6

  Withdraw the needle once the syringe contains 2 to 4 cc of blood, and hold a gauze pad in your left hand to the puncture site with firm pressure for at least 2 minutes (you may hand over this responsibility to someone else in an emergency).

• 7

  Carefully slip the needle into the cap, or remove the needle, dispose of it properly and plug the syringe with the rubber cap provided in the ABG kit. Make sure that the syringe contains no air.

• 8

  Fill out the label as instructed, and affix it to the syringe for ABG analysis before leaving the room.