ABG Sampling/ Arterial Prick

Indications:

Equipments:

Procedure:
 Give infant pacifier or sucrose solution to suck 2 minutes before procedure
 Radial artery most commonly used and relatively safe
 Position the hand and palpate the artery and mark it with finger nail print
 Apply strict sterile technique (first povidone-iodine swab then alcohol swab)
 1 ml heparinized syringe is used for ABG sampling
 Insert needle at 300 angle
 Take blood up to 5% of total blood volume (4 ml for 1 kg baby)
 Apply gauze and pressure for 5 minutes

Precautions:
 More heparin gives false result of less pH and less PaCO 2
 Expel air bubbles and tightly cap the syringe otherwise false result of more PaO 2
and less PaCO2

Complications:
 Hematoma (use smallest guage needle and apply pressure for 5 minutes)
 Thrombosis of artery
 Infection (Staph Epidermidis)
 Osteomyelitis
 Median Nerve injury (avoid pricking brachial artery)
 AV fistula (repeated sampling)
 Umblical Artery Catheterization (UAC)
Indications:

Equipments:

Procedure:
 Place infant supine and diaper wrapped around the legs
 Under strict sterile technique prepare the tube and attach it with syringe and
flush it
 Drape and prepare the area (povidone-iodine then alcohol swab on umbilicus)
 Apply umbilical tape around the umbilicus
 Cut the cord leaving 1 cm stump
 Grasp the stump and identify the artery and dilate it with forceps
 After inserting catheter secure it

Precautions:
 Never advance a catheter when it is secured in place
 Never touch the tubes without gloves and with strict sterile techniques
 Never allow air to enter the end of catheter

Complications:
 Infections
 Thrombosis/ embolism
 Hypertension (long term complication)
 Loss of extremity (rare)
 Paraplegia
 Haemorrhage (accidental)
 Vessel perforation
 Refractory hypoglycemia
 Urinary ascities, NEC and peritonitis
 Factitious hypernatremia and hyperkalemia
 Umblical Vein Catheterization (UVC)
Indications:

Equipments:

Procedure:
 Place infant supine and diaper wrapped around the legs
 Under strict sterile technique prepare the tube and attach it with syringe and
flush it
 Drape and prepare the area (povidone-iodine then alcohol swab on umbilicus)
 Apply umbilical tape around the umbilicus
 Cut the cord leaving 1 cm stump
 Grasp the stump and identify the vein and dilate it with forceps
 After inserting catheter secure it

Precautions:
 Never advance a catheter when it is secured in place
 Never touch the tubes without gloves and with strict sterile techniques
 Never allow air to enter the end of catheter

Complications:
 Infections (commonest)
 Portal Vein thrombosis and portal vein hypertension (2nd common)
 Thrombosis/ embolism
 NEC
 Cardiac-perforation, pneumopericardium, endocarditis, fungal infection in right
atrium
 Colonic perforation
 Pulmonary complications