My surgeon has ordered some lab work prior to upcoming surgery, including an ABG, arterial blood gas. I remember my mom having these about 18 years ago, and how much she despised and feared them. But maybe techniques have changed. The nurse at my surgeon’s office described them as “very painful”, but I’ve heard others say “meh, it wasn’t that bad”.
So, have you had a blood gas test? How bad was it (on a scale of one to ten)? What factors affect how painful it is? I’m very, very difficult to get an IV into. Does that seem to indicate I may have a problem getting a blood gas drawn?
My son had a gazillion of these. They hurt, but not like HURT. On a scale of 1 to 10 in needle pain, with a finger prick being a 1 and a spinal tap being a 10, I’d put this at about a 4 or 5. Kid Kalhoun never freaked or tried to get away. It was just more painful than getting blood drawn.
The test can be painful. If the person drawing it is experienced, it takes only a couple seconds, so even though painful, it’s over quickly.
The state of your veins isn’t an issue.
The most common site for drawing an ABG is the inside of the wrist on the thumb side.
(feel your pulse there)
The drawer will prepare the syringe, and while holding it in his or her dominant hand, will feel for your radial pulse. I usually feel for the pulse with my index finger, then again with my second finger leaving a space between my fingers. After swabbing the site with an antiseptic (betadine is common) I slowly put the needle into that space directly over the pulse. It has to be advanced slowly so as not to go through the vessel. I advance until blood begins to fill the syringe. Because an artery has more pressure than a vein, the syringe fills quickly by itself.
Once the srynge has filled with enough blood, I quickly pull the needle and apply pressure with sterile gauze for a full 5 minutes to avoid bruising.
The syringe may go into ice, although, if it’s processed quickly, it doen’t need to be, then to the lab. It has to be processed within 10 minutes or so, because the gasses desolved in the blood change rather quickly.
My mom has had lots of these done, and she didn’t think that they were a big deal, but her hands looked really bad when she was done. She bruises up very easily so that probably has something to do with it.
These answers are reassuring. I hate needles in my wrist, but think I’m gonna ask for a shot of lidocaine, so that should help. It’s good to know that my having lousy veins shouldn’t affect things. And it’ll all be worth it when I get my surgery!
As I remember it (Kid Kalhoun was pretty young, so I haven’t done a bedside monitoring of the process in at least a decade), the pain is due to the location and the fact that it’s an artery (more pressure). This was for asthma, pneumonia, bronchitis-type ailments. It measures how much oxygen is actually getting into your blood. I forget the range exactly, but if I remember correctly, 95-100 is good. Kid K at times was in the 60s I think. I could be totally wrong on that, though.
ABG sticks hurt more than regular sticks because arteries have nerves, and veins don’t.
But really, it should be more of an “Ohh, that smarts!” than “YAAAHHHH!!! You’re KILLING me!!”
As for lidocaine - don’t bother. The lidocaine injection hurts just as much as the blod draw. Also, lidocaine is a cardiac med in addition to an anaesthetic. Its presence in the skin at the site of the ABG draw could skew the lab results.
It’s my understanding that the artery is deeper, so the needle has to go in deeper. Also, needles in the wrist do tend to be painful. Also, according to an article on Yahoo Health, arteries have more nerve endings than veins.
I’m not quite sure why my surgeon wants a blood gas, other than it’s one definite way to tell if I’m a smoker (I’m not, but I’m sure people lie about that to doctors), because being a smoker is a big factor when it comes to major surgery.
A couple of things about this. One, that thing about the lidocaine shot hurting just as much, that’s what the nurses always tell me about IV’s, but it’s not true. I’m not implying that you’re lying, just that IV sticks hurt like hell, whereas the lidocaine needle’s just a little stick. Maybe the ABG doesn’t hurt as much as getting an IV. Also, about it being a cardiac med and skewing the results, I’m not trying to be argumentative, but both nurses I’ve talked to, as well as the Yahoo Health article, all said that lidocaine is sometimes used. I don’t see why it would be, if it could skew the results.
I’ve had a few over the last year, and they’ve always given me a numbing shot first. If they are willing to give you lidocaine, I’d say do it. With the numbing shot it feels more like strong pressure, and really is not all that bad. You’ll be fine.
Yes. To me, an IV only feels like pressure if they give lidocaine first. As far as them being “willing”, I’ve had enough medical procedures over the years to be a very strong advocate for myself. This is how my last IV convo went:
Me: Can I have some lidocaine first?
Tech: Why would you want lidocaine? That only means you’ll be getting two sticks instead of one.
Me: Yeah, but the lidocaine stick is only a little sting, but when you go digging for a vein, it’s gonna hurt.
Him: I won’t dig for a vein. If I don’t get it, I’ll try somewhere else.
Me: But if you give me the lidocaine, you can go digging, and save me yet another stick! Plus, the lidocaine needle is tiny, and the IV needle is big.
Him: Okay, if you really want lidocaine, I’ll get some. It’ll take a few minutes for me to go get it, though.
Me: I’ll wait.
You know, I thought that too for years. My nursing instructors said it, so it must be true.
But my new neighbor is a vascular physiologist (a lab rat) and he tells me that veins indeed have pain receptors. They are fewer than arteries, but they are there. So when a patient says, this IV hurts my vein, I have to believe them.
As long as you believe your patients when they say something hurts, that’s what matters.
norinew - I’ll stand by my memories of the absolutely most painful injection I ever had being lidocaine. Unfortunately, it was prep for a lumbar puncture, so it was necessary to endure. Maybe there was a burr on the end of the needle, but it was really unpleasant. Fortunately, the puncture itself was as OK as one of those can be.
I believe you and I had an exchange about this in another thread. You said veins didn’t have nerve endings, and I said they must, or one IV med wouldn’t hurt worse than another. F’rinstance, whatever they use to knock me out for surgery burns like a sumbitch for about two seconds (doesn’t burn longer than that, because after two seconds, I’m out). So, yeah, I’ve known for quite a while that veins have nerve endings. But apparently, arteries have more. All in all, though, the answers in this thread have calmed me down quite a bit. Now if I can just talk that darned tech into using some lidocaine, I think I’ll be fine. Of course, no matter what, I’ll get through it one way or another.
Are you sure you’re not confusing lidocaine with novocaine? Because, IME, novocaine injections hurt like a bitch, and lidocaine injections don’t. Could just be a case of YMMV.
A spinal tap really shouldn’t be a 10. I suppose that the headache that some folks get after could approach 10, but the procedure itself shouldn’t be that bad.
Of course I’ve never had one, just reporting on what the patients I’ve done them on have told me.
I also tell my patients that a “10” means the pain is so bad they’re tearing the skin of their arms off with their teeth to distract themselves from the pain.
I’ve also had patients who said that they’d rather have an ABG than an IV stick. YMMV.
Yes! That’s why I asked the neighbor! I meant to get back and say something, but forgot. Sorry. Novocainehasn’t been used much in years. Many people say novocaine when meaning lidocaine. 1% Lido doesn’t hurt much, but 2% does, and lido with epi burns evn more, IMO.
You can get plenty of information about the test here.
Blood gases are tested for a couple of reasons. One is to check your acid/base balance in the blood and check for any respiratory or kidney disorders that would throw that balance out of whack.
Also, they’re often taken during surgery, to monitor the oxygen and carbon dioxide of the blood and make sure the patient’s getting enough oxygen.
I like getting blood gases in the lab - there’s a “Drop everything!! BLOOD GAS!!!” mentality that takes over every time the pneumatic chute delivers a blood gas sample on ice from one of the floors.
No, no, no! A “10” is when I am tearing the skin off of the Doctors arms with my teeth because the pain is so bad.
norinew I have found IVs near my wrist to painfull. While you are making a stink about the lidocaine stuff, ask if you can have your IV placed higher up on your arm. I find it much more comfortable. Bring a small box of chocolates or something to use as a bribe.
