Chapter 13: Diagnostic tests
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Post‐procedural considerations
Monitoring and follow‐up of the patient are essential. After the blood sampling procedure, nursing staff should monitor the patient for early and late signs and symptoms of potential complications. Active, profuse bleeding at the puncture site might raise suspicion of vessel laceration. Femoral artery bleeding carries an increased risk of circulatory compromise because of the large calibre and deep location of the vessel, which allow large amounts of blood to accumulate without initially giving rise to clinical findings (Chernecky and Berger [32], Danckers and Fried [41], Pagana and Pagana [177]).
A rapidly expanding haematoma may compromise regional circulation and increase the risk of compartment syndrome, especially in the forearm. This manifests as pain, paraesthesia, pallor and absence of pulses. Paresis and persistent pain may indicate a nerve lesion. Limb skin colour changes, absent pulses and distal coldness may be seen in ischaemic injury from artery occlusion caused by thrombus formation or vasospasm. Infection at the puncture site should be considered in the presence of regional erythema and fever (Chernecky and Berger [32], Danckers and Fried [41], Pagana and Pagana [177]).
