How do you take a vbg?

I'm doing some shadowing before starting F1, and I took a vbg from a patient by connecting a butterfly needle + tube to a syringe like in the image, getting blood and squirting it into the abg syringe. The F1 watching me said it's weird and he usually just takes blood with the abg needle itself or uses a syringe + needle directly attached. My problem with these methods is that you don't get the flashback that you do with a butterfly needle so you know you're in the vein.

I guesd there's 3 methods I can see here:

1) take blood from a vein with the abg needle/syringe itself

2) attach a needle to a syringe directly, take blood then transfer to abg syringe

3) (what i do) attach a syringe to a butterfly set, take blood then transfer to abg syringe.

What do you usually do/ what's considered 'normal'? Thanks!

6EEBEF75-F50F-41A8-BC64-9F041927F49A.jpg.jpeg

6EEBEF75-F50F-41A8-BC64-9F041927F49A.jpg.jpeg

Reply 1

Beska

If it's a VBG alone, you can just connect the ABG syringe directly to the butterfly and take it that way. If you're taking lots of bloods including a VBG (or a VBG off the back of a venflon), I use a syringe (like your picture) and then decant the blood into the ABG syringe. There's no way to connect 2 syringes together so I usually use a clean needle to decant from one syringe to the other. I then just take the tops off the vacutainer bottles and squirt in some blood and then put the lid back on (pushing a needle into them is dangerous territory for a needlestick). I've never seen or heard of anybody using the ABG syringe + needle directly into a vein... that's a bit odd... it's like the classic needle and syringe for taking bloods which I've never seen anybody do, ever.

in reality it makes no difference, if your method works for you then go for it.

Edit: Actually no, I have used a needle and syringe once - somebody impossible to get blood off but only tiny tiny vessels, used an insulin size-ish needle and syringe for an INR....

(edited 5 years ago)

Reply 2

Helenia

Original post by Beska

I do needle + syringe loads, I don't like the Vacutainer sampling system.

OP, any of the above are reasonable options. If you're ONLY taking a VBG then it's perfectly fine to just use the designated syringe, and you do still get flashback. If you're taking it with other samples then using a needle (butterfly or standard) and syringe or whatever collection system your trust uses is more sensible.

Reply 3

Democracy

ABG syringe on the end of a butterfly needle :yy:

Reply 4

Chief Wiggum

If I'm only doing a VBG, I put the VBG syringe onto a butterfly needle.

If I'm doing VBG+other bloods, I put a 10ml syringe onto a butterfly needle, then transfer the blood from the 10ml syringe into the various tubes.

Reply 5

dekg140

Original post by Beska

I had no idea I could connect the abg syringe directly to the butterfly. Mind blown

Original post by Democracy

ABG syringe on the end of a butterfly needle :yy:

Original post by Chief Wiggum

Thanks so much guys!! Seems like what I'm doing makes sense then, I guess the F1 was just baffled by the fact that I had the tubing of the butterfly connected to the syringe, as he'd only ever attached a needle directly onto syringe and taken blood that way

Reply 6

Chief Wiggum

Original post by dekg140

Huh, weird. Depends on hospitals I guess, but I've never seen anyone use straight needle+syringe. Everyone uses butterflies.

Reply 7

Helenia

Original post by Chief Wiggum

Huh, weird. Depends on hospitals I guess, but I've never seen anyone use straight needle+syringe. Everyone uses butterflies.

Butterflies were in short supply in some places when I was more junior, so we were only allowed them for trickier patients. A straight needle is still good sometimes (and not just into the femoral!)

Reply 8

Etomidate

I use whatever is left in the poorly stocked trolley, which can often only include an alcohol swab, a skin swab and an empty tourniquet box, but needs must.

Reply 9

junior.doctor

Original post by Etomidate

I use whatever is left in the poorly stocked trolley, which can often only include an alcohol swab, a skin swab and an empty tourniquet box, but needs must.

Wow, you actually have empty boxes in your trolley? What sort of luxury establishment is this? I normally have to take a rusty screw out the side of the trolley... :tongue:

Reply 10

seaholme

I think I've used all of the above methods depending on if I am taking other bloods or not aaaand yep whatever the hell I can find in terms of equipment. There's only so many multiple locked store rooms with ranks of poorly filled unlabelled drawers on various wards I can bring myself to search through sometimes. I find the easiest way is actually butterfly plus syringe exactly like in your photo, for me anyway. A needle and syringe in a delicate situation with fragile old people veins, I often find the act of pulling back on the syringe can displace the needle fractionally but significantly enough to come out of the vein, whereas the tubing between the butterfly and the syringe stops that error from occurring. Also if I find something dodgy on the VBG I sometimes find I want to send off other bloods so a regular syringe > actual ABG syringe because any remaining blood isn't contaminated by heparin. But each to their own!