Interpretation of arterial blood gases requires a systematic assessment of oxygenation, ph, standard bicarbonate shco 3. Arterial blood gas abg interpretation for medical students, osces and mrcp paces this section presents how to interpret arterial blood gases. Each case is then followed by an explanation of the acidbase status, the oxygenation status and a summary of the patients clinical picture. It explains each component in turn followed by clinical examples to work through. Blood gas analysis in canines has not become as popular as in medical field. Blood gas analysis provides critical information to healthcare providers that assists in the diagnosis and treatment of a variety of metabolic and respiratory disorders. The chinese university of hong kong sampling of arterial blood for blood gas analysis will yield information on. Historically, clinical laboratory testing was performed by medical laboratory scientists and medical laboratory technicians.
The terminology of arterial blood gas abg is complex and confusing. Describe 4 primary forms of acidbase imbalance, including causes and symptoms. Arterial blood gas analysis is an essential part of diagnosing and managing a patients oxygenation status and acidbase balance. The present article is an attempt for the simplified approach for the bedside interpretation of abg. These disorders are termed complex acidbase or mixed disorders. Indications, interpretations, and clinical applications m etabolic derangements and respiratory distress are common presenting problems in emergency medicine. Interpreting and using the arterial blood gas analysis. Correct interpretation of the information obtained from blood gas analysis allows the clinician to make appropriate decisions regarding diagnosis, therapy, and prognosis related to respiratory function and acidbase status. Interpreting arterial blood gases successfully larkin. Arterial blood gas case questions and answers in the space that follows you will find a series of cases that include arterial blood gases. Applications of abg o to document respiratory failure and assess its severity o to monitor patients on ventilators and assist in weaning o to assess acid base.
Download arterial blood gas interpretation pdf download. Blood gas evaluation link to condensed version case 5. 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. Accurate and timely interpretation of an acidbase disorder can be lifesav. Each institution has its own protocol for ordering, collection and analysis of blood gases. 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 analysis is a fundamental skill in modern medicine yet one which many find difficult to grasp. The acidbase balance is maintained by the respiratory, cardiovascular, and renal systems. This article provides the physiological basis for assessing abgs perioperatively and presents a systematic approach to blood gas analysis using the romanski method. As pao2 increases, more oxygen diffuses into the red blood cells, where it combines with hemoglobin to form oxyhemoglobin. An arterial blood gas abg analysis can tell you about a patients oxygenation, acidbase balance, pulmonary function, and metabolic status.
This tictactoe technique involves a few charts to help you visualize abgs. Practices related to processing of blood gas samples are not standardized in the republic of croatia. Explain 3 mechanisms by which the body regulates acidbase balance. Arterial blood gas analysis dr abdullah pg 2 medicine amu aligarh 2. Blood gas sample data allow the reader to practice abg interpretation. Blood gas and critical care analyte analysis chapter objectives 1. The usefulness of this diagnostic tool is dependent. Interpreting an arterial blood gas abg is a crucial skill for physicians, nurses, respiratory therapists, and other health care personnel. Creative ways to teach arterial blood gas interpretation. Abg interpretation abg analysis arterial blood gases acidbase balance. The lesson talks about interpretation of arterial blood gas results.
Interpreting an arterial blood gas abg is a crucial skill for physicians, nurses, respiratory. The value of timely and accurate interpretation of blood gas results cannot be questioned. Physiological approach to assessment of acidbase disturbances. Overview abg sampling interpretation of abg gas exchange acid base status 3.
The bodys regulation of ph is influenced by both the respiratory and the. Identify normal arterial blood gas values and interpret the meaning of abnormal values. Approach to blood gas interpretation uct anaesthesia. Use this handy reference guide to help you understand and interpret arterial blood gas results, and assess patients oxygenation, acidbase.
The main determinants of pao 2 are the inspired oxygen concentration, alveolar gas exchange, and, to a lesser extent, tissue oxygen. Pdf arterial blood gases abg results reflect underlying pathology and interpretation of the results are often compounded by ongoing. Is the blood gas taken from a patient on room air or supplemental oxygen. In this article, well describe a stepbystep approach to interpreting abg results, which tell you about oxygenation and acidbase balance in the patients blood and guide treatment decisions. Abg interpretation a guide to understanding abgs geeky. This indispensable tool helps you assess and monitor critically ill patients in the icu or other critical care settings.
List the types of samples that can be analyzed for blood gas and analyte concentrations. Interpretation of arterial blood gases abgs david a. The arterial blood gas abg measures the acidbase balance ph and oxygenation of an arterial blood sample. The medical plan of care for the neonatal patient includes the frequency of blood gas determination, and it is every care providers responsibility to be cognizant of each blood gas sample drawn on the patient. Arterial blood gas interpretation felicia ratnaraj internal medicine pgy 3 pm report. 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. It is made worse by the printouts generated by recent microprocessors. The oxygen tension pao 2, carbon dioxide tension paco 2, acidity ph, oxyhemoglobin saturation sao 2, bicarbonate hco 3 helpful in critically ill patients. Introduction blood gas analysis is done to determine the acidbase balance in the blood. Sign up to receive my blogemail updates and receive a free handout to develop clinical j. There are four classic disturbances in traditional acidbase equilibria.
Test your knowledge on the webs most interactive blood gas learning tool. Weve created this guide, which aims to provide a structured approach to abg interpretation whilst also increasing your understanding of each results relevance. Interpretation of arterial blood gases requires a systematic assessment of. Oxygenation of blood through gas exchange in the lungs. But it is often encountered that many students dont know how to read abg, and thats why we are providing arterial blood gas.
Lack of knowledge of the effects of body temperature on results of blood gas monitoring may lead to wrong. Mixed acid base disorder more than one problem is present both co 2 and metabolic parameters have shifted towards the. In blood gas analyzers the samples are always kept constant at a temperature of exactly 37c during the measurements, and therefore results are not correct if body temperature differs from 37c. Your doctor may run a blood gas analysis or arterial blood gas abg test if you are showing the signs of an oxygen, carbon dioxide, or ph imbalance such as confusion or difficulty breathing. Interpretation of the arterial blood gas selflearning packet see swift for list of qualifying boards for continuing education hours.
Explain the types of errors that can occur with blood gas analysis. Its possible to have more than one disorder influencing blood gas values. Arterial blood gas interpretation demystified physician assistant. Abg quick interpretation parameter acidosis normal alkalosis reflects ph 7. The usefulness of this diagnostic tool is dependent on being able to correctly interpret the results. Do not be intimidated by abg interpretation no longer. Download arterial blood gas interpretation pdf list price. Arterial blood gas abg interpretation determining acidosis and alkalosis.
Identify the relationship between oxygen saturation and pao2 as it relates to the oxyhemoglobin dissociation curve. An abg is a blood test that measures the acidity, or ph, and the levels of oxygen o2 and carbon dioxide co2 from an artery. Practice rational testing interpreting arterial blood gas. Arterial blood gas abg analysis is a crucial skill for perioperative nurses, in particular the rn circulator. It helps with the determination of oxygen and carbon dioxide, the two important gases which deals with human and animal life.
For example abgs with an alkalemic ph may exhibit respiratory acidosis and metabolic alkalosis. Assess oxygenation arterial oxygen tension pao 2 is the partial pressure of oxygen in arterial blood. View the video lesson, cheat sheets and practice questions to master abg interpretation. An abg can be used to assess respiratory compromise, status peri or postcardiopulmonary arrest, and medical conditions that cause metabolic. Body will not overcompensate when it comes to acidbase balance so.
Arterial blood gas analysis is a common investigation in emergency departments and intensive care units for monitoring patients with acute respiratory failure. Blood gas values can always be explained by two or more coexisting acidbase disorders. 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. Patients are often required to be checked for arterial blood gas analysis to find what exactly is happening in the body of patients system. 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 interpretation is something many medical students find difficult to grasp weve been there. Arterial blood gases po 2 so 2 measured calculated pulse oximetry pco 2 ph bebd hco 3venous co 2 oxygenation ventilation acidbase.
Canine blood gas analysis deals with the analysis and interpretation of dissolved gaseous status and acid base level of blood. Oxygen content of blood is affected by level and affinity state of hemoglobin example is co poisoning. Understanding the underlying pathophysiology associated with a patients condition and how it relates to an acidbase imbalance will also be discussed. Pdf on feb 8, 2018, abdul razak and others published interpretation of blood gas find, read and cite all the research you need on. The most important points when assessing a patient are the history, examination and basic observations. Each hemoglobin molecule contains four atoms of iron and therefore can combine with four molecules of oxygen. Interpret the results of various arterial blood gas samples. The hydrogen ions are buffered by desaturated hemoglobin, and hco3 is transported out of the eryth rocytes into the plasma figure 63.
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