pulmonary function test with ABG or 1 ABG or whatever...

[chdurie2]

Anyone had a pulmonary function test with ABG or 1ABG or whatever they call it? That's where they take blood from an artery to measure oxygen levels etc. I think it's mostly a test for smokers (the ABG part) since they also measure carbon monoxide, I think, but my sleep doc ordered it allong with my cpap titration and MSLT. Anyway there's a reason for my question.

The woman said they have to take the blood from an artery, not a vein, and they tpically use the wrist. She said it is very painful. She sprayed a healthy amount of ether on my wrist to numb it. Now I am no wimp when it comes to needles and used to give myself shots for years and have been stuck by many nursess and docs for many years in connection with an illness I once had, as well as took numerous IVs. So I have a long history of being stuck and it never bothered me.

I don't know if I have ever had blood taken from an artery before. But this thing was the most painful thing I have ever had, I think, and the woman (blood tech) did not get any blood. After about a minute she pulled out the needle and said the artery had rolled over on her. She asked if I wanted to try again with the other wrist. I said no. She said the doc would decide whether the test was important enough to re-order it or would let it go that we tried and couldn't get it.

I would like to know some frame of reference from folks who have had the test--is this thing the most painful thing on the planet, or do you think this tech screwed up and jabbed me in a way that was unnecessarily painful? I realize this is a subjective thing, but frankly I was surprised that it hurt so much I did not want to do it again--at least not then and maybe not ever. I'm usually pretty patient with medical folks when they can't get good veins, miss, etc. when drawing blood. I also should mention that I am extremely sensitive when it comes to my hands--once before an operation, they wanted to insert an iv in my hand and i told them no way--we had a big to-do about it, with me insisting that they use the inside elbow, and eventually i got my way. so the wrist is near the hand, but I figured the wrist would be okay.

anyone know about this? thanks.

caroline

[beneyw]

I went thru a standard Pulmonary Function test with various 'implements' or Spirometer while being seated in a sealed off chamber. The tech speaks and directs you to do certain breathing tests. It is painless, non-invasive and requires no drawing of blood.

[Wulfman]

Caroline,

I'm confused......
There's an "A1C" test which checks for checks for blood glucose levels (by blood draw) and there's a pulse oximetry test which is done by clipping a little thing on the end of your finger and requires no blood being drawn because it uses infrared light.

Best wishes,

Den

[Handgunner45]

ABG is an arterial blood gas. A much more accurate way to determine blood oxygen levels than a pulse oximeter.

[Guest]

have had a few ABG's - think 3 of them - two of them were unconscious so no big deal as I was in pulmonary failure - by the way not a smoker and never was

a couple months after the pulmonary failure episode my doc wanted a baseline ABG so did it - the lab was connected with a teaching hospital but not in the hospital building (they had a lab there too but that wasn't where the draw was but they might have had to send me there) -

the head tech drew it - she had two onlookers (students) who also felt the artery before she jabbed it and she had showed them how it would move around - she was pretty careful during it

pain? don't recall a whole lot of it but have known of others who have had it

and missing it? sound pretty bad but then I had a doc miss a vein repeatedly in my hand one day and was pretty irked about that

[unclebob]

Hi chdurie2,

Thanks for your post.

Not sure if I had an ABG test but did have CHF and spent several weeks in the hospital before, during, and after my Aortic valve replacement. Had so many needles I had calloses on my arms where they regularly stuck me.

In your case it seems to me the tech may have blown it. This sort of thing happened to me a few times particularly with the IV in the hand - I just hate those. One time the tech couldn't get it twice on the same hand and had to call up the chain. She couldn't get it either on the other hand so had to get the head honcho (this was a well known major hospital) who went in half way up the arm and it worked. Recently, a tech said I had deep veins so this may be a factor.

One of my best experiences was in the same hospital. I was there for a two week span and they did blood tests every morning - very early!! The young oriental lady quietly woke me up, said "take a big breath then oop" then when she did it, she said - "big breath - oop" and it was all done and I swear, I didn't feel a thing. She wasn't in on weekends and it wasn't the same.

One of my worst needles, that I can remember anyway, just happened this year. Was having cataract surgery and they stuck a needle in the side of my temple - that really hurt! Had the other eye done about ten years ago and I sure don't remember that happening.

Just keep thinking - this is good for you as they are only trying to help!

All the best.

Bob F

[dllfo]

they did a PFT, PST (drew blood from my wrist) and the Methacholine challenge test.

Only the blood being drawn from my arterys hurt. A clown did it the first time and he was horrible. A good nurse came it, hit the artery and I was done. I would NOT have allowed a second chance at it.

I agree, I think it is usually poorly done. I had no pain relief offered. AND I was on morphine at the time. So ...I guess if it hurt that bad, it would REALLY hurt someone who was just sprayed with some lightweight stuff.

Good luck...PFT and Methacholline Challenge are not painful.

[Guest]

the blood gas test is pretty common practice in some sleep labs, it is a more accurate way of measuring the oxygen saturation levels in the blood vs. a pulse oximeter which isn't very accurate (reason insurance will not accept Pulse Oximeter for a diagnosis).

[krousseau]

Arterial blood gases are to measure oxygen and carbon dioxide levels in the arterial blood. It is not just for smokers. It does hurt more than a venipuncture but is not the most painful thing done to people. I have done them many times-there are ways to reduce the pain. The wrist is the easiest place to do the test and it is usually done there unless the person is having repeated tests and has had the wrist arteries "punctured" recently. I would say the comment about pain was made inappropriately by someone who was not sure of their skill and wanted to "set you up" to expect it and not be surprized at failure. You were right to refuse a second stab from this person. The doctor may not have really needed ABG's-the finger oximeter may have been fine for the purpose. If you need them ask the tech how often he/she does them and that they have one chance so get their best tech on the job. My own policy was to stick once and if by chance I didn't get the sample-to get someone else to do the second stick. Rarely missed and have done an ABG stick on a person in convulsions.

[chdurie2]

thanks, kay. the sleep doc ordered abg, so i think he wants abg -- question whether he will pass or take oximeter, which i don't recall ever having done, even though i did have pulmonary function test.

how do you minimize the pain of this thing? (maybe if done right it would not have been so painful, but still i'd like to know in case we do this again.)

what i thought was bizarre was, how do you have a needle in someone for like a minute and you're not getting any blood and yet you persevere? time doesn't fly when you're in pain, so maybe it was 30-45 seconds, but still i would think you would pull it out after 10-15 seconds and no blood. no one has ever not gotten blood from me when trying. there's no swelling or anything, but the area seems to still hurt at times.

done on someone in convulsions? very impressive.

thanks again.

caroline

[krousseau]

The surface "anesthetic" they used isn't effective for the deeper pain you experience with ABG's. Even lidocaine injected above the puncture site would only give surface anesthesia. It is the needle going into the artery that causes pain (among other things)-if the tech goes in at the wrong angle it causes more pain. For arterial sticks it is very straight/vertical. Some people's arteries are tougher, some roll, and that makes it hurt more. It is also normal for it to be sore at the site for several days-more so if the tech tried to "hunt" for the artery-that is to reposition the needle a little without pulling the needle completely out.
The blood test is more accurate that oximetry and does give some other very important info about blood ph, CO2,& O2.

[BetterBreathinBob]

Drawing blood from the artery is really an art and having the right touch is so important. Practice makes perfect and the best at doing these are the Respiratory therapists on staff. The ABG can hurt near the wrist because the nerve is nearby.

Some hospitals use lidocaine first with a smaller needle but then there are 2 sticks, 1 with the lidocaine the other for the ABG.

Teaching hospitals are usually the worst because the young interns practice on the patients.

My advice is always question the necessity of any lab draw, ask the physician why he needs this data. It's your arm, not his.

[Blue Lou]

ABGs are usually no more painful that regular blood work...HOWEVER...Having said that...The artery in the wrist is VERY close to a sensory nerve...And, if the nerve is touched...It can light you up like a Christmas tree...Sorry...

[chunkyfrog]

The discussion occurred eight years ago.
Maybe the clumsy tech has gotten better--or is in a different field.
Let's hope time has given us better technology, more accurate oximeters, etc.

[Respiratory Therapist]

I am a respiratory therapist, and I have performed many ABG's. The pain level for patients varies significantly; I've had students practice on me because I have almost no pain during an ABG blood draw. The amount of pain can vary depending on the exact location in the wrist where the blood is drawn, but there is no way of knowing precisely where nerves are located, so pain levels will vary even with multiple draws on the same person.