The value of such data depends upon the ability of the doctors to interpret the results properly and if the analysis is made systematically, it becomes interesting for the doctors and fruitful for the patient analysed report of abg helps the clinician in. Arterial blood gasses, or abgs, may be among the most complex and confusing parts of nursing practice. Dimensions of critical care nursing dccn, 322, 8487. Arterial blood gases play an important role in the workup and management of critically ill patients and patients with a variety of pulmonary complaints and disorders.
But it is often encountered that many students dont know how to read abg, and thats why we are providing arterial blood gas. An arterial blood gas result can help in the assessment of a patients gas exchange, ventilatory control and acidbase balance. Clear, tolerating an oropharyngeal airway, on 40% oxygen via face mask b. Respiratory acidosis occurs when breathing is inadequate and paco 2 or respiratory acid builds up. The 6 easy steps to abg analysis are listed below for easy reference and will be explained in more detail in the sections that follow. Fully operational on battery and with customizable test panels, it can be shared between several departments. Arterial blood gas abg analysis is an essential part of diagnosing and managing a patients oxygenation status and acidbase balance. Each hemoglobin molecule contains four atoms of iron and therefore can combine with four molecules of oxygen. Apr 29, 2016 pao2 this is the partial pressure of oxygen dissolved within the arterial blood and will determine oxygen binding to haemoglobin sao2. B she was thrown from her horse at a local event a a. Written by a senior lecturer in critical care, this easytofollow guide will help practitioners at all levels develop their skill in assessing arterial blood gas results.
Fortunately, there are some easy ways to remember how to decipher these important lab results. Weve created this guide, which aims to provide a structured approach to abg interpretation whilst also increasing your understanding of each results relevance. Arterial blood gas analysis is an essential part of diagnosing and managing a patients oxygenation status and acidbase balance. Blood gas and ph analysis and related measurements. The concentration of oxygen and carbon dioxide in the blood, whose partial pressures are measured along with other factors such as blood ph in order to assess oxygen saturation and other metabolic indicators in patients, especially those with respiratory disorders. The results from an abg will indicate how well a patients respiratory system is working. Intensive care, combined military hospital, post code1206. If youre new here, you may want to subscribe to our rss feed. Blood is most commonly drawn from the radial artery because it is easily accessible, can be compressed to control bleeding, and has less risk for vascular occlusion. Combine the information from the ph, paco2 and the bicarbonate determine the primary disturbance is there any metabolic or respiratory compensation. In case of delay, the sample should be placed in ice and such iced sample can be processed upto 2 hours without affecting the blood gas values. In our first three examples, the patients were uncompensated.
We may be presented increasingly with venous blood gases 2. Blood can be drawn via an arterial stick from the wrist, groin, or above the elbow. So direct measurement of ph, pao 2, paco 2 are most precise in medicine. When one thinks of abg analysis, oxygenation may come to mind first. For this second edition of arterial blood gases made easy we have remained true to. An arterial blood gas abg test measures the amounts of arterial gases, such as oxygen and carbon dioxide. The radial artery on the wrist is most commonly used to obtain the sample. An arterial line in an appropriate patient is likely to save the patient victim of venepuncture multiple painful needles in the ed and during their hospital stayconsider doing a venous gas much of the important blood gas information can be elicited from a venous blood gas and it is much less painful. Consider an arterial line early in the ed stay if the patient is really sick. If repeated arterial blood gas analysis is required, it is advisable to use a different site such as the other radial artery or insert an arterial line. Results of your arterial blood gas test usually are available in less than 15 minutes. Analysis of arterial blood gases a comprehensive approach. This information indicates a patients acidbase balance, the effectiveness of their. Arterial blood gas definition of arterial blood gas by.
Its importance as a key tool in the workup of acutely unwell patients rivals that of the ecg and the chest xray. Pdf arterial blood gas analysis is a common investigation in emergency. After the puncture, sterile gauze should be placed firmly over the site and direct pressure applied for several minutes to obtain hemostasis. Woodruff, msn, rnbc, cns, cmsrn, cen 6 easy steps to.
Abg interpretation a guide to understanding abgs geeky. Arterial blood gas analysis is an essential part of diagnosing and managing a patients. Arterial blood gas analysis plays an indispensable role in the assessment and management of patients with a huge range of acute medical and surgical problems. Interpretation of the arterial blood gas emergencypedia. Key physiology including the carriage of respiratory gases is incorporated and applied. Without knowing them, your patient could easily go.
However, the femoral artery and brachial artery can be used if necessary. The new abl9 blood gas analyzer is specially designed for critical care environments running only a few tests per day. Differences are subtle but important on venous gas. Please view my other nursing videos at nursing assessment part 1 s. Arterial blood gas analysis is a common investigation in emergency departments and intensive care units for monitoring patients with acute respiratory failure. The investigation is relatively easy to perform and yields information that can guide the management of acute and chronic illnesses. Clinical and laboratory standards institute, 940 west valley road, suite 1400, wayne, pennsylvania 190871898, usa. The 6 easy steps to abg analysis are listed below for easy reference and will be explained in more detail in. Abg interpretation a guide to understanding abgs geeky medics. It is used to assess the effectiveness of ventilation.
Arterial blood gas analysis workshop case study 1 initial information i ed staff member has asked you to assist. For example, they are used to guide the adjustment of ventilator parameters on. However, abgs can offer more than just information on the respiratory system they also indicate how well a patients kidneys and other internal organs the metabolic system are functioning. Determination of the constant of the differential blood gas apparatus, with a note on the specific oxygen capacity of blood. Analysis of arterial blood gases abg is an essential investigation in the management of critically ill patients as it provides important information about alveolar ventilation, oxygenation, and acidbase balance measurement of abg includes measurement of three parameters, i. A method of estimating the oxygen and carbonic acid in small quantities of blood. An abg test requires that a small volume of blood be drawn from the radial artery with a syringe and a thin needle, but sometimes the femoral artery in the groin or another site is used. Abg analysis is a diagnostic tool that allows the objective evaluation of a patients oxygenation, ventilation and acidbase balance coombs, 2001. As it is unable to combine with oxygen and it also decreases the oxygen carrying capacity of blood. However, the more complicated and in some ways more important part of abg analysis is ph regulation. Patients are often required to be checked for arterial blood gas analysis to find what exactly is happening in the body of patients system.
Thus, will be impaired in lung disease such as copd. Components of the arterial blood gas the arterial blood gas provides the following values. A blood sample for abg analysis may be drawn by percutaneous arterial puncture from an arterial line. Paco2 this is the partial pressure of carbon dioxide dissolved within the arterial blood. One advantage of subscribing to rss feeds is that you dont have to constantly revisit this site to check for updates within specific sections you might be interested in because your browser or feed reader will do this for you automatically on a regular basis plus you can even get email. The book is called arterial blood gas anslysis made easy isbn. Apr 03, 2020 an arterial blood gas requires the nurse to collect a small sample of blood generally, a full 1 ml.
The usefulness of this diagnostic tool is dependent on being able to correctly interpret the results. The selection of which radial artery to draw from is based on the outcome of an allen. Interpreting abgs arterial blood gases made easy ausmed. Most doctors struggle with arterial blood gas abg interpretation. The extra co2 combines with water to form carbonic acid, causing a state of acidosis a common occurrence in emphysema respiratory alkalosis can occur as a result of hyperventilation metabolic acidosis is when there is a decrease in bicarbonates and a buildup of lactic acid occurs. Arterial blood for bloodgas analysis is usually drawn by a respiratory therapist and sometimes a phlebotomist, a nurse, a paramedic or a doctor.
Everyone can read an electrolyte level, but when faced with a list of abgs, most nurses wilt. It provides a measure of oxygen diffusion across the alveoli into the blood. Interpretation of arterial blood gas pubmed central pmc. The normal range for a healthy person is 35 45 mmhg. Scholander 190580 constructed a syringe with a calibrated capillary attached for analysis. Arterial blood gas abg made easy for dummies youtube. Jan 26, 2015 other useful information from arterial blood gases. The interpretation of arterial blood gases australian. This page is based on the bestseller in the us for the past decade on abgs. A high paco2 respiratory acidosis indicates underventilation, a low paco2 respiratory alkalosis indicates hyper or overventilation. How to interpret an arterial blood gas analysis lecturio. This is a nonfinal version of an article published in final form in. The real value of an abg comes from its ability to provide a. Fourstep method of interpreting arterial blood gas analysis.
Feb 15, 2017 therefore, the 6 easy steps to abg analysis was developed to provide nurses with an accurate and systematic method of easily interpreting arterial blood gases. Creative ways to teach arterial blood gas interpretation. S 21yearold woman who on the way to hospital has become increasingly drowsy. How to interpret arterial blood gas results correspondence. Jan 16, 2019 in this guide, we will teach you the eight 8 steps on how to interpret and analyze arterial blood gas abg results using the tictactoe method. This tictactoe technique involves a few charts to help you visualize abgs. Blood gas values mixed venous gases measures oxygen left in the. The abg analysis is mainly used to evaluate gas exchange in the lungs. It is simple, perhaps simplistic, but it will hopefully arm the reader with the tools and.
Arterial blood gas sampling the society for acute medicine. Blood gas analysis and critical care medicine american. But your doctor cant diagnose you based on an arterial blood gas test alone. Abg or arterial blood gas analysis made easy facebook. It is also used to assess integrity of the ventilatory control system and to determine the acidbas level of the blood. Arterial blood gases due east lancashire nhs student.
Disorders of acidbase balance can create complications in many disease states, and occasionally the. If repeated arterial blood gas analysis is required, it is advisable to use a different site such as the other radial artery or. Arterial blood gases abg, a clinical test that involves measurement of the ph of arterial blood and the amount of oxygen and carbon dioxide dissolved in arterial blood, is routinely used in the diagnosis and monitoring of predominantly criticallyacutely ill patients being cared for in hospital emergency rooms and intensive care units. Sep 01, 2007 arterial blood gas analysis plays an indispensable role in the assessment and management of patients with a huge range of acute medical and surgical problems. Arterial blood gas abg is now widely done in hospitals. Rating is available when the video has been rented. Arterial blood gas abg interpretation is something many medical students find difficult to grasp weve been there. Acidosis is caused by an accumulation of co2 which combines with water in the body to. Arterial blood gas determinations of pco2 provide the most accurate determinations of the adequacy of alveolar ventilation, but capillary, transcutaneous, and end tidal techniques are also useful.
May 23, 20 arterial blood gas overview powerpoint abg overview presentation severinghaus j w et al. It is of vital importance but is not used in determining patients acid base status and normally low readings indicate hypoxaemia. Therefore, the 6 easy steps to abg analysis was developed to provide nurses with an accurate and systematic method of easily interpreting arterial blood gases. We often encounter patients who are critically sick and need monitoring more than vitals like bp and pulse rate. As pao2 increases, more oxygen diffuses into the red blood cells, where it combines with hemoglobin to form oxyhemoglobin. Arterial blood gas abg analysis is a crucial part of diagnosing and managing a. Blood is drawn anaerobically from a peripheral artery radial, brachial, femoral, or dorsalis pedis via a single percutaneous needle puncture, or from an indwelling arterial cannula or catheter for multiple samples. This information indicates a patients acidbase balance, the effectiveness of their gas exchange and the state of their ventilatory. The abl80 flex blood gas analyzer is small, portable, easy to use and ideal for lowvolume settings.
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