ABG made easy

1. STEPHY STANLY

2.  Acid base status
 Degree of oxygenation of blood and
adequacy of alveolar ventilation
 Continous arterial blood pressure
monitoring in an emergency

3.  1ml or 2 ml disposable syringe
 20 gauge disposable needles
 Heparin1;1000
 Alcohol swab disposable gloves
 Arterial catheter for continous pressure
monitoring
 Tegaderm

4.  Identify patient by name and explain
procedure
 Temperature
 Heparinize 2 ml syringe
 Wash hands wear gloves
 Palpate the radial,brachial or femoral artery

5.  perform allen test

6.  palpate for maximum pulsation
 at 45-60 degreee angle
 once the artery is punctured ,arterial pressure
will push up the piston of the syringe and a
pulsating flow of blood will fill the syringe.

7.  apply firm pressure -for 5 mins.
 air is removed and cap the syringe needle
and keep it in a container of ice.

8.  Arterial blood gas analysis
is an essential part of diagnosing and
managing a patient’s oxygenation status and
acid-base balance

9.  pH = Pka + log base/acid
 Acidemia – H+ conc in plasma is greater than
normal
 Alkalemia – H + conc in plasma is less than
normal

10.  Excess heparin : low pH, PCO2 & HCO3
 Contamination with room air : PaO2,
pH, PaCO2
 Delayed analysis :
 By 10 mts – pH decreases by 0.01
 PCO2 increases by 1 mmHg
 O2 conc decreases by 0.001


11.  Normal PH : 7.35 – 7.45
 acidosis< 7.35
 alkalosis > 7.45

12.  Normal PaCO2- 35-45
 High PaCO2 > 45 PH low Resp
acidosis
 Low PaCO2 < 35 PH high Resp
alkalosis

13.  Normal HCO3 – 22-28 meq/L
 PH low HCO3 low Metabolic
acidosis
 PH high HCO3 high Metabolic
alkalosis

14.  Determine if there is a compensatory,
mechanism working to try to correct the pH.
Values of HCO3 and CO2

15. Analyse the partial pressure of oxygen and
saturation

16. Normal Values
(At sea level)
Range:
pH 7.35--‐7.45
pCO2 35--‐45
mmHg
pO2 80--‐100
mmHg
O2
Saturation 95--‐100%
HCO3
Base Excess
22--‐26
mEq/L
+or--‐2

17.  ABG's: pH 7.31 PCO2 55 mm Hg HCO3
- 28
mEq/L

18.  Ans
uncompensated respiratory acidosis

19.  ABG's: pH 7.31 PCO2 55 mm Hg HCO3-
35 mEq/L

20.  Compensated respiratory acidosis

22.  Ph- 7.30
 Pco2 -30
 Po2-68
 O2 sat- 92%
 HCO3-14

23.  Compensated metabolic acidosis

24.  Ph -7.18
 Pco2 44
 Po2-92
 O2 sat-95%
 Hco3-16

25.  Uncompensated metabolic aciosis

26.  Ph- 7.27
 Pco2-53
 Po2-50
 O2 sat-79%
 HCO3-24

27.  Uncompensated respiratory acidosis with
hypoxemia