Question

3. You are performing a modified Allen's test to the right arm on Ms. Gordon, a 22-year-old African American woman. You notice that her fingertips are cold to the touch. After release of the ulnar artery, it takes 12 seconds for color to re turn to the palm. What actions should you take at this time? What are the possible causes of a negative Allen's test in this patient? . While performing an arterial puncture on Ms. Gordon, the patient in Critical Thinking Question 3, you encounter th following difficulties. Describe all possible solutions for each problem The tip of the needle touches the bedside table before insertion into the patient. A. B. The artery seems to roll away from the needle each time you approach it. You are having difficulty feeling a pulse in the right (nondominant) arm C. You observe a blood flash in the hub of the needle, and then blood flow stops. D.

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Answer 1

Ans)3) A procedure called the Allen test may be used to find out if the blood flow to the hand is normal. For the Allen test, the health professional drawing your blood will apply pressure to the arteries in your wrist for several seconds. This will stop the blood flow to your hand, and your hand will become cool and pale.

Negative modified Allen test – If the hand does not flush within 5-15 seconds, it indicates that ulnar circulation is inadequate or nonexistent; in this situation, the radial artery supplying arterial blood to that hand should not be punctured.

But in the question it clearly denotes that finger tips are cold to touch & after the release of Ulnar artery it takes 12 seconds to return to palm so that's the cause for negative Allen's test.

4) A) Aseptic technique should be strictly use. Touching of the tip of needle to the bedside table before insertion to patient is wrong practice. If at all this happens then that needle should be discarded & new needle should be taken.

B) Yes, this situation is likely to happen as there is high pressure in arteries & pulsation where experience will help in this situation as when to insert the needle will be best achieved by the person who is well experienced.

C) A weak pulse means you have difficulty feeling a person's pulse (heartbeat). An absent pulse means you cannot detect a pulse at all.

The most common causes for a weak or absent pulse are cardiac arrest and shock. This causes a weak pulse, rapid heartbeat, shallow breathing, and unconsciousness. Shock can be caused by anything from dehydration to a heart attack.

So expertize opinion will be needed.

D) When you insert the needle in the artery or vein you see a flashback in the hub indicating that the needle is in the vein. But you puncture the needle & still insert little more you won't able to collect the blood, so carefully observation is needed.