JRSM >
Volume 97, Number 10 >
Pp. 505
Mount Sinai School of Medicine, 1425 Madison Avenue, Box 1240, New York NY, 10029, USA
E-mail: Eric.Altschuler{at}mssm.edu
Reporting a high rate of needle-stick injuries, Mr Elmiyeh and his colleagues (July 2004 JRSM1) offer no detail on the techniques. I would not be surprised if arterial puncture was overrepresented. Here I describe a one-handed method that might lessen the hazard.
The most commonly used method to obtain arterial blood is to palpate for the pulse with fingers from one hand while inserting the needle with the other hand directly juxtaposed or under the fingers from the first hand. This carries risks of needle-sticks if an uncooperative or disoriented patient moves. Another established method is to insert the needle at an anatomical location where arterial pulsations are visible through the skin. This is one-handed, but in many patients it cannot be used because pulses are not visible transcutaneously. My one-handed method works as follows. (1) Palpate for the arterial pulse and mark the approximate location of the pulse with an indentation from the cap of the closed syringe. (2) Again locate the pulse by palpation and make a mental note of its relation (if there is any deviation) from the indented mark. (3) Clean the area with alcohol. (4) Insert the needle with one hand, using the mark as a guide. (5) If the blood is drawn with a safety needle, recap it with one hand.
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