So... the coroner comes in with a body. Tells us he needs an order and a requisition for a carboxyhemoglobin level. Apparently there was concern on scene that this deceased had quite a few kerosene heaters running in the house and the concern is for carbon monoxide poisoning.Well we wrote up the blood gas lab slip and gave it to him (the coroner) with the appropriate specimen labels. I was standing right there, with a little free time on my hands (imagine that- free time in an ER! yikes~!)...and I told my attending MD, "I'll go do it if you're busy" (cool!).
So I went with the coroner and set about to draw this "arterial" sample...!!!
Then I got to thinking....
1) Does it have to be arterial? Isn't the COhb level the same arterial vs. venous?
2) If it has to be arterial, how do you palpate the artery on a corpse?????
...hmmmm
Anyways, after consulting with the respiratory therapist on duty (who I trust) they explain that it really won't matter at all but to try for arterial if possible.
So I set about to do a radial artery stick. First I thought about doing Allen's Test (yeah right), then I proceeded to do it just by "feel" in the same place I've always done it into the radial artery.
Got a good flash in the ABG syringe, but it was a S-L-O-W draw. Usually I'm quite used to this brisk, bright red flow from the artery; you could definitely tell this was different. It took a few seconds, but we got it done and sent it off.
Something you don't get to do every day that's for sure!
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The easiest way to get blood from a corpse is to stick the femoral vein, or the left ventricle.
ReplyDeleteABG or VBG it doesn't matter (doesn't matter in the living either).
the PCO2 will be ~ the same
the HCO3 will be ~ the same
the pH will be ~ the same
And you can get your PO2 from a clip on the finger.