Respiratory Cloud Clinical Skills Library

Clinical knowledge review

Contraindications

Use these educational prompts with current orders, protocols, patient assessment, facility policy, and supervising-clinician direction.

Skill

Arterial Puncture

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Contraindications Conditions identified as reasons to avoid or defer the procedure pending authorized clinical review. View list Relative contraindications Factors requiring individualized risk-benefit assessment, added precautions, or a modified approach. View list

Contraindications

Review these conditions before proceeding and follow current orders, protocols, facility policy, and supervising-clinician direction.

  • Arterial grafts or shunts in the limb

Relative contraindications

Use individualized risk-benefit assessment, added precautions, or a modified approach as authorized for the patient and setting.

  • Coagulopathy or anticoagulant therapy (↑ risk of bleeding/hematoma)
  • Thrombocytopenia (low platelet count <80,000/μL)
  • Severe hypotension or shock (poor perfusion, unreliable sample)
  • Recent vascular surgery at puncture site

Sources

Supporting sources include peer-reviewed research, evidence-based clinical practice guidelines, professional standards, and foundational respiratory care references, as applicable to the skill.

  1. Egan’s Fundamentals of Respiratory Care, 11th Ed. (2021)
  2. Irwin & Rippe’s Intensive Care Medicine, 9th Ed. (2022)
  3. AARC Clinical Practice Guideline: Sampling for Arterial Blood Gas Analysis (2013)
  4. AARC CPG 2013
  5. Egan’s 11e