If you are not a member, we invite you to view the subscriber benefits at membership benefits. Read each question carefully and choose the best answer. In order for our analysis to be effective, notes will have to be written next to the results on our lab slip. Used to determine along with ph and co2 source of acid base imbalance.
Body will not overcompensate when it comes to acidbase balance so. Mistakes in arterial blood gas abg interpretation are common in clinical practice. An easy step by step guide to understanding the abg. Does the co2 or the hco3 go the opposite direction of theph. The first step is to look at the ph and assess for the presence of. You are called to see a 54 year old lady on the ward. Determine if paco2 is under normal, acidosis, or alkalosis. Abg sampling technique before you can interpret an abg you must, of course, obtain a sample of arterial blood.
Respiratory acidosis overdose, pneumonia, cns disorder 5. She is three days postcholecystectomy and has been complaining of shortness of breath. The 6 easy steps to abg analysis are listed below for easy reference, and will be. Below are some brief clinical scenarios with abg results. Interpreting and using the arterial blood gas analysis. Arterial blood gases abg results reflect underlying pathology and interpretation of the results are often compounded by ongoing disease processes and clinical interventions. Arterial blood gas abg interpretation for medical students. We need to keep these goals in mind as theyll come up later in the steps for the technique. But it is often encountered that many students dont know how to read abg, and thats why we are providing arterial blood gas. Arterial blood gas abg analysis plays a pivotal role in the management of critically ill patients. Abg s are often used in conjunction with other tests to check how well the lungs are able to move oxygen into the blood and remove carbon dioxide from the blood. I confirm the need for the abg and idenbfy any contraindications box 1. The first step in analyzing abgs is to look at the ph.
Note the clients temperature on the laboratory form. The following six step process helps ensure a complete interpretation of every abg. It discusses the various components on an abg report, the normal ranges and the significance of abnormal readings. Arterial blood gas analysis is an essential part of diagnosing and managing a patients oxygenation status and acidbase balance. Arterial blood gas analysis for emergency medicine registrars. Assessment of gas exchange pao2 vs spo2 alveolararterial o2.
Interpretation of arterial blood gases pocket icu management. Easy way to interpret abg values in 7 simple steps overview of the 7 simple steps. Step by step approach to arterial and venous blood gas analysis step 1. Use an easy 6step method to analyze blood gases for the right answer. Determine if ph is under normal, acidosis, or alkalosis. Locate the radial artery with your index and middle fingers perform allens test where you compress both the radial and ulnar arteries at the same time. Follow the guidelines below to make the most out of this exam. Jan 16, 2019 we need to keep these goals in mind as theyll come up later in the steps for the technique. Abg interpretation steps to abg interpretation step 1. Effect of sample storage temperature and time delay on blood. Many methods exist to guide the interpretation of the abg.
Although no randomized controlled study has ever been performed evaluating the benefit of abg analysis in the icu, it is likely that this technology stands alone as that diagnostic test which has had the greatest impact on the management of critically ill patients. It involves puncturing an artery with a thin needle and syringe and drawing a small volume of blood. The following is a simplified explanation of abgs, including a practical method for interpreting results. 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. Determine the cause of the acidosis or alkalosis by looking at the pco2 and hco3if ph correct and quick responses j anesth crit care j anesth crit care open access 55. 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. If po2 and sao2 values are decreased, the patient has hypoxaemia. Easy steps to abg analysis to determine acidbase disorders. The hand should become white, release the ulnar artery and the colour should return to the hand. This guide provides a structured approach to abg interpretation, including several worked examples to put your interpretation skills to the test. Check for acidosis or alkalosis the first thing you need to determine when checking abg results is the acidity of the blood which is determined by the value of the ph. Clinical examination a comprehensive collection of clinical examination osce guides that include step by step images of key steps, video demonstrations and pdf.
Arterial blood gases can be challenging to all nurses despite their level of expertise. If there is any delay in processing the sample, the blood can be stored on ice for approximately 30 min with. Practice the 6 easy steps to abg analysis with more examples with explanations. Take these 6 easy steps to abg analysis request pdf. Sep 15, 2010 stages of labor nursing ob for nursing students stages of labour nclex explained video lecture duration. Arterial blood gas abg analysis lippincott nursingcenter. The purpose of this course is to provide the learner with basic. The ph level in a healthy human should be between 7. O determination of pao2x pao2 is dependant upon age, fio2, patmy as age the expected pao2ge pao2 109 0. Arterial blood gas analysis can be used to assess gas exchange and acid base status as well as to provide immediate information about electrolytes. 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. Arterial blood gas abg analysis linkedin slideshare.
Always record details of 0, therapy and respiratory support. There are eight 8 steps simple steps you need to know if you want to interpret abg results using the tictactoe technique. Cell buffering that acts within minutes to hours 2. Confusion often begins with trying to remember many random rules and lacking a standardized approach to abgs. This discussion does not include some methods, such as analysis of base excess or stewarts strong ion difference.
Easy steps to abg analysis to determine acidbase disorders if this is your first visit, be sure to check out the faq by clicking the link above. With that in mind, the main steps in interpreting an arterial blood gas in greater detail are presented below. An arterial blood gas abg test measures the acidity ph, levels of oxygen, and carbon dioxide in arterial blood. This ensures that there will still be a blood supply to the hand should the abg cause a blockage in the radial artery. There are five case studies, work through each using the 5 step approach to arterial blood gas analysis. The interpretation of arterial blood gases australian. Mar 28, 2015 6 easy steps to abg analysis duration. We dont only want to interpret abg values for fun, they have a very important purpose. Determine if hco3 is under normal, acidosis, or alkalosis. The arterial blood gas abg analysis is a lab test that measures the acidbase balance and oxygenation of an arterial blood sample, usually obtained by direct arterial puncture. However, the acceptable temperature and delay between the time of collection and arterial blood gas analysis remain unknown 1. Try to interpret each abg and formulate a differential diagnosis before looking at the answer. If you are a current member, login using the form below. The investigation is relatively easy to perform and yields information that can guide the management of acute and chronic illnesses.
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. This role can be well exemplified by considering the concept of respiratory failure. The hco3 is greater than 26, and therefore is alkalotic. So heres a 20question practice exam for your nclex. Interpretation of arterial blood gas pubmed central pmc. Arterial blood gas analysis assesses a patients partial pressure of. It is also useful to have access to any previous gases. Bicarb rises 1 meql for every 10 mmhg elevation in pco2 or for every 1 up of pco2, ph should fall. Normal values to check in abg before actually starting to interpret the abg reports, one needs to remember the following normal values, without which, it is impossible to analyze anything. Abg quick interpretation parameter acidosis normal alkalosis reflects ph 7. Determine if the ph is within the normal range, or reflects acidosis or alkalosis. Alternately, the abg results can be transcribed onto another paper for analysis see example one below for the format. Interpretation of arterial blood gases is a sample topic from the pocket icu management to view other topics, please sign in or purchase a subscription anesthesia central is an allinone web and mobile solution for treating patients before, during, and after surgery.
This term remains nonspecific and does not help much in deciding whether the respiratory failure is due to. Abg kit with labels the steps for obtaining an abg sample are as follows attaching a 23gauge needle to an abg syringe w 0. The following steps should be used as a guide but the best way to learn is at the bedside with experienced supervision. Clinical examination a comprehensive collection of clinical examination osce guides that include stepbystep images of key steps, video demonstrations and pdf mark schemes. The most common problems that are encountered include nonarterial samples, air bubbles in the sample, inadequate or excessive anticoagulant in the sample, and delayed analysis of a noncooled sample. This article is available as html full text and pdf. There are eight 8 steps simple steps you need to know if you want to interpret abg results using the. Rating is available when the video has been rented. 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. Analysis of arterial blood gases a comprehensive approach.
It only addresses acidbase balance and considers just 3 values. As long as the normal values box 2 are remembered and the four step system is carefully followed, it will be possible for abgs to be accurately interpreted. Fourstep method of interpreting arterial blood gas analysis. The 6 easy steps to ag analysis are listed below for easy reference, and will be explained in more detail in the sections that follow. Garima aggarwal resident iind yr department of medicine5th august moderator dr. Nurses can learn valuable information about their patients by analyzing the abg results.
When one thinks of abg analysis, oxygenation may come to mind first. The goal of interpreting abg values is so that we can decipher what is happening to our patient, so that we can implement a plan to help them improve. Arterial blood gas analysis is used to measure the ph and the partial pressures of oxygen and carbon dioxide in arterial blood. Abg interpretation a guide to understanding abgs geeky. Find, read and cite all the research you need on researchgate. The usefulness of this diagnostic tool is dependent on being able to correctly interpret the results. 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.
Abg interpretation a guide to understanding abgs geeky medics. To ensure accuracy, it is important to deliver the sample for analysis promptly. The components of an abg analysis are pao 2, sao 2, hydrogen ion concentration ph, paco 2, hco 3. This is the first of a twopart unit on arterial blood gas abg analysis, and focuses on background information and basic interpretation of abgs where no evident compensation is taking place. It is an essential part of diagnosing and managing a patients oxygenation status and acidbase balance. Pesi healthcare is improving healthcare by connecting outstanding speakers and authors with nurses and healthcare providers to provide premier accredited continuing education in multiple formats live, onsite, webinars, webcasts, books. 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. Your account has been temporarily locked due to incorrect sign in attempts and will be automatically unlocked in 30 mins. Youll be right most of the time if you remember this simple table.
Abg analysis 2016 tazkai llc more free nursing school aids at disclaimer information at normal abg values ph 7. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. 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. Abg examples abg exam questions for medical students and. Mar 20, 2015 results of abg analysis can be biased by preanalytical factors, such as time interval before analysis, temperature during storage and the syringe type. This information indicates a patients acidbase balance, the effectiveness of their gas exchange and the state of their ventilatory. Analyze the paco 2 paco 2 45 acidosis paco 2 normal blood ph range is 7. An arterial blood gas abg is a blood test that is performed using blood from an artery. Arterial blood gases abg cardiovascular osce skills. However, the more complicated and in some ways more important part of abg analysis is ph regulation.
Apr 09, 2019 try this third set of practice exam and master the art of interpreting abgs. This method is simple, easy and can be used for the majority of abgs. In addition, you will find tables that list commonly encountered acidbase disorders. Renal compensation that is not complete for 35 days in acute. If the results do not make sense, either your interpretation was wrong or there may be some additional processes at work that were not recognized on the initial analysis. Clinically important errors may occur at any of the above steps, but abg measurements are particularly vulnerable to preanalytic errors. Analyze the ph the first step in analyzing a865 is to look at the ph. Respiratory compromise, which leads to hypoxia or diminished ventilation. Abg analysis practice examples for nursing students. In the back of your mind you would like to take a more active role in this scenario, if only you were more comfortable with abgs. Nurses often have difficulty interpreting arterial blood gases abgs. Woodruff, msn, rnbc, cns, cmsrn, cen 6 easy steps to. Request pdf take these 6 easy steps to abg analysis an abstract is unavailable. 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.
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