Arterial blood gas analysis for emergency medicine registrars. Interpret the results of various arterial blood gas samples. Therefore in an arterial blood gas test, the blood sample is drawn from an artery. Arterial blood gas abg analysis linkedin slideshare. Without knowing them, your patient could easily go. This poster offers a basic level of understanding of abgs for medical students. Mar 27, 2012 arterial blood gas analysis is widely available in hospitals. The selftesting questions and glossary make it particularly useful.
Arterial blood gas abg interpretation for medical students, osces and mrcp paces this section presents how to interpret arterial blood gases. However, the more complicated and in some ways more important part of abg analysis is ph regulation. Arterial blood gas values given in table 1 are general ranges for. Therefore doctors around the world have agreed to retain mmhg as the unit of blood pressure measurement. The interpretation is often easy, however, correlating the same with the. Fourstep method of interpreting arterial blood gas analysis. An abg is the most accurate representation of a patients clinical status and correct interpretation can lead to quicker and more accurate changes in the. This indispensable tool helps you assess and monitor critically ill patients in the icu or other critical care settings. Proper management of these disorders is not possible without the understanding of basic blood gas interpretation and acidbase balance physiology. Interpretation of arterial blood gas pubmed central pmc. Making sense of arterial blood gases nursing times. The amount of carbon dioxide dissolved in arterial blood. Today every icu provides rapid and automated blood gas testing twentyfour hours a day.
Interpretation of arterial blood gas article pdf available in indian journal of critical care medicine 142. Arterial blood gases must be carefully evaluated on a 30 to 60minute basis to diagnose changes in oxygenation, ventilation, or perfusion or the development of drug toxicity e. A venous blood gas often correlates well with arterial blood gas findings except for pao2 unless values are extremely abnormal, and can often be used successfully as a screening tool. In practice the differences between these are negligible woodrow, 2004 with the normally accepted range being 95100 per cent esmond, 2001. Each hemoglobin molecule contains four atoms of iron and therefore can combine with four molecules of oxygen. How to interpret an arterial blood gas analysis lecturio. Both blood gas quizzes are based on information presented in my pulmonary physiology web sites, especially the four most important equations in clinical practice. Basic physiological concepts, anion gap, respiratory acidosis, metabolic alkalosis, metabolic acidosis. Mistakes in arterial blood gas abg interpretation are common in clinical practice. It explains each component in turn followed by clinical examples to work through. Interpreting an arterial blood gas abg is a crucial skill for physicians, nurses, respiratory. Oxygenation of blood through gas exchange in the lungs.
Classification and interpretation of blood gas values are based. Learn vocabulary, terms, and more with flashcards, games, and other study tools. When one thinks of abg analysis, oxygenation may come to mind first. Arterial blood gas an overview sciencedirect topics. The patient has a low ph acidemia the pco 2 is high respiratory acidosis and the bicarbonate is high metabolic alkalosis. The paramedics arrived after 10 minutes, during which cpr had not been attempted. Through simple diffusion, gases move from an area of higher. Arterial blood gas abg analysis is a fundamental skill in modern medicine yet one which many find difficult to grasp. Interpreting and using the arterial blood gas analysis. Easy blood gas quiz with answers, by lawrence martin, md. Assessment of gas exchange pao2 vs spo2 alveolar arterial o2. Arterial blood gas analysis workshop page 4 of 8 arterial blood gas analysis workshop scenario 1 initial information a 75 year old man presents to the accident and emergency department after a witnessed out of hospital vf cardiac arrest.
The following is a simplified explanation of abgs, including a practical method for interpreting results. Here youll get an excellent overview and a stepwise approach to interpret abg analysis. We have educated blood gas related basics and advanced interpretation all over the world for the past 12 years and have been the best. Results of your arterial blood gas test usually are available in less than 15 minutes.
This book provides readers with the core background knowledge required to understand the abg, explains how it is used in clinical practice and provides a unique system for interpreting results. Arterial blood gases abg can be difficult and confusing to understand at first. How to interpret arterial blood gas results correspondence. Everything that you need to know about arterial blood gasses. 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. Explain the types of errors that can occur with blood gas analysis. Medical nursing dept life is a struggle, not against sin, not against the money power, not against malicious animal magnetism, but against hydrogen ions. Arterial blood gas sampling the society for acute medicine.
Arterial blood gas interpretation made easy on meducation. 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. For this second edition of arterial blood gases made easy we have remained true to. Interpret the ag in the clinical context of the patient in front of you abg interpretation what numbers do you get on an abg. Arterial blood gas analysis is used to measure the ph and the partial pressures of oxygen and carbon dioxide in arterial blood. The emphasis in this handy manual on blood gases is on interpreting readings and wisely using the information derived. Arterial blood gas abg analysis is an essential part of diagnosing and managing a patients gas exchange and acidbase balance status, and can also be useful in providing immediate information about electrolyte status it provides a near immediate reflection of the physiology of your patient, allowing you to recognise and treat pathology more rapidly. The real value of an abg comes from its ability to provide a.
Tic tac toe method arterial blood gas abg interpretation. As pao2 increases, more oxygen diffuses into the red blood cells, where it combines with hemoglobin to form oxyhemoglobin. Once youve mastered this technique, youll be doing actual abg interpretation. Arterial blood gas values have five basic components that you use to assess patients.
Arterial blood gas abg interpretation is something many medical students find difficult to grasp weve been there. 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. Acidbase balance and blood gas interpretation springerlink. Arterial blood gas analysis workshop resuscitation council uk. The first covers basic physiology and concepts required for interpretation of blood gas results under four headings. Arterial blood gas interpretation the arterial blood gas provides the following values. The pf ratio ratio between the pao 2 and the inspired oxygen concentration expressed as a fraction is a useful guide to the presence and severity of impaired. Arterial blood gas abg analysis plays a pivotal role in the management of critically ill patients.
Alternatively, run the blood gas, preferably yourself, immediately after taking it 4. Interpretation of abg gas exchange acid base status. A patient is brought back to the floor from the operating room on a patient controlled analgesia pca pump with hydromorphone. Identify the relationship between oxygen saturation and pao2 as it relates to the oxyhemoglobin dissociation curve. Mencken what is an abg arterial blood gas drawn from artery radial, brachial, femoral it is an invasive procedure. In cases where blood gas values do not fall into any of the above classifications, an answer unable to determine will appear when using the interpreter. Fio2 the percentage of inspired oxygen that you took the blood gas on ph normal range 7. Arterial blood gas analysis is a common investigation in emergency departments and intensive care units for monitoring patients with acute respiratory failure. What this means is that water h2o can combine with co2 and form. Abg interpretation a guide to understanding abgs geeky. This information indicates a patients acidbase balance, the effectiveness of their gas exchange and the state of their ventilatory.
During most blood testing procedures, blood is drawn from a vein. It is made worse by the printouts generated by recent microprocessors. The low ph in combination with the high pco 2 tells us that the respiratory acidosis is the primary process. If you continue browsing the site, you agree to the use of cookies on this website. Interpreting abgs arterial blood gases made easy ausmed. All you really need to know to interpret arterial blood gases. Arterial blood gas analysis is an essential part of diagnosing and managing a patients oxygenation status and acidbase balance. The only difference is that in a blood gas we are measuring the saturation of arterial blood sao2 and in pulse oximetry we are measuring the saturation of peripheral capillary blood spo2. Arterial blood gas analysis for emergency medicine registrars very helpful investigation in critical care you should be an expert you need a system, and must be thorough they are not really that hard part 1 the basics part 2 compensation part 3 metabolic acidosis part 4 metabolic alkalosis. Patients are often required to be checked for arterial blood gas analysis to find what exactly is happening in the body of patients system.
Its a test that is used to assess how well oxygen is being distributed throughout the body and how well carbon dioxide is being removed. But at this point the oxygen content in the blood is used up by the tissues. It is simple, perhaps simplistic, but it will hopefully arm the reader with the tools. Components of the arterial blood gas the arterial blood gas provides the following values. List the types of samples that can be analyzed for blood gas and analyte concentrations. If the pascal unit is used for blood pressure measurement, a normal blood pressure of 12080 mmhg would be an unwieldy 1596010640 pa. Arterial blood provides more information than venous blood with regard to acidbase and oxygenation status. When the ph is normal, it will be fully compensated. Understanding acidbase balance and interpreting arterial blood gas results can.
But it is often encountered that many students dont know how to read abg, and thats why we are providing arterial blood gas. Body will not overcompensate when it comes to acidbase balance so. That is the confidence that you will have after reading this book. Everyone can read an electrolyte level, but when faced with a list of abgs, most nurses wilt. The principle of optical plethysmography is made use of to. Abg quick interpretation parameter acidosis normal alkalosis reflects ph 7. This tictactoe technique involves a few charts to help you visualize abgs. Arterial blood gas bicarbonate respiratory system free. The patient hits his pca button several times in the first hour. I have also made an idcardsized version which can be easily used on the ward. Identify normal arterial blood gas values and interpret the meaning of abnormal values. Arterial blood gasses, or abgs, may be among the most complex and confusing parts of nursing practice. Arterial blood gas analysis workshop learning outcomes at the end of this workshop candidates should be able to.
An arterial blood gas, or abg for short, is a test that measures the blood levels of oxygen pao2, carbon dioxide paco2, and acidbase balance ph in the body. Mar 18, 2020 interpretation of arterial blood gas analysis seems complicated. It is important to understand the physiological principles underpinning blood gas analysis, so these will be outlined briefly before exploring some practice issues for patients undergoing arterial blood gas sampling. Aug 11, 2008 arterial blood gas interpretation slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Combine the information from the ph, paco2 and the bicarbonate determine the primary disturbance is there any metabolic or respiratory compensation. The interpretation of arterial blood gases australian. Analysis of arterial blood gases a comprehensive approach. Within a hospital setting, understanding what can be done with a client before a sched. Blood gas analysis is one of the major tools in assessing the. Arterial blood gas abg analysis may appear a complex and daunting task, but a little guidance can make it much simpler. Aug 4, 2014 this poster offers a basic level of understanding of abgs for medical students. The usefulness of this diagnostic tool is dependent. It also has some applications in general practice, such as assessing the need for domiciliary oxygen therapy in patients with chronic obstructive pulmonary disease. Arterial blood gas interpretation abg arterial blood gas analysis is used to measure the partial pressures of oxygen pao2, carbon dioxide paco2, and the ph of an arterial blood sample.
The emphasis of this booklet is to simplify the major concept of abg interpretation in a way that resonates to the readers interest and reduces mundane memorization. Nov 02, 2011 interpretation of thearterial blood gas analysis dm seminar dr. Vishal golay 2112011 slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. The chinese university of hong kong sampling of arterial blood for blood gas analysis will yield information on. Abgs made easy arterial blood gas acid base balance. But your doctor cant diagnose you based on an arterial blood gas test alone. Abg interpretation a guide to understanding abgs geeky medics. Fortunately, there are some easy ways to remember how to decipher these important lab results. Woodruff, msn, rnbc, cns, cmsrn, cen 6 easy steps to. Interpretation of arterial blood gases abgs david a. This multiplechoice blood gas quiz is an easier version of a blood quiz posted in 2009. Disorders in acidbase balance and oxygenation present some of the most challenging problems in the postoperative care of surgical patients. Blood gas and critical care analyte analysis chapter objectives 1. Abgs made easy for nurses w tic tac toe method for arterial blood gas interpretation.
It is simple, perhaps simplistic, but it will hopefully arm the reader with the tools and confidence to make better sense of abg results in future. Oxygen content o2ct, oxygen saturation sao2, and bicarbonate hco3 values are also measured. Students can work around the table, looking at ph, then co2 and then hco3 and find the answer in the correct box. An arterial blood gas abg analysis can tell you about a patients oxygenation, acidbase balance, pulmonary function, and metabolic status. The investigation is relatively easy to perform and yields information that can guide the management of acute and chronic illnesses. However, its a crucial skill for nurses, physicians, respiratory therapists, and nursing students to learn.
Easy way on how to interpret arterial blood gases abgs with tic tac toe first, we need to lay the foundation and talk about what three lab values you need to look at when trying to figure out abgs, how to determine if that value is consider normal, an acid, or basic alkalotic, and what fancy terms are used once the abg is figured out. Interpretation of arterial blood gases requires a systematic assessment of oxygenation, ph, standard bicarbonate shco 3. Although no randomized controlled study has ever been performed evaluating the benefit of abg analysis in the intensive care unit icu, it is likely this technology stands alone as the diagnostic test which has had the greatest impact on the management of critically ill patients. If youre new here, you may want to subscribe to our rss feed. Abg equipment 3 electrode system that measures three fundamental variables po2, pco2 and ph all others parameters such as hco3 computed by software using standard formulae. This measures the number of hydrogen ions in your blood, which may indicate conditions such as copd, asthma, pregnancy, diabetic ketoacidosis dka, lung disease, liver disease, or drug use. Blood gas interpretation for neonates better safer care. The most important points when assessing a patient are the history, examination and basic observations. Shortly thereafter, the nurse walks in the room and finds him somnolent and difficult to arouse. Arterial blood gas samples can be obtained from a number of sites, including the following radial artery at the wristthe most popular site for arterial blood sampling because of its easy accessibility, superficial location, and availability of collateral circulation. Weve created this guide, which aims to provide a structured approach to abg interpretation whilst also increasing your understanding of each results relevance. As it is unable to combine with oxygen and it also decreases the oxygen carrying capacity of blood. Comparison of blood gas analysis at different sites.
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