The Arterial Blood Gas (ABG) Analyzer interprets ABG findings and values. If the pH < 7.35, then the patient is acidosis.⁵ Remember, the lower the pH number, the higher the acid level in the body. We’ve looked at programs nationwide and determined these are our top nursing schools. This will determine if the changes in the blood gas are due to the respiratory system or metabolically driven. It's possible to have more than one disorder influencing blood gas values. You know all nursing jobs aren’t created (or paid!) A base deficit (i.e., a negative base excess) can be correspondingly defined in … An ABG should be expected if the surgery is a long one, or if the patient will be on the ventilator for an extended period of time. You are called to see a 54 year old lady on the ward. Usefulness. Watch it to see if you know the correct answers! Here are some great resources you might use for further study. An arterial blood gas (ABG) is a test that measures the blood levels of oxygen and carbon dioxide as well the level of acid-base (ph) in the body. Lab values: pH 7.23, paCo2 37, HCO3 18 * 3. In combination with the HCO3, the nurse will be able to fully comprehend the blood gas. [2] Metabolic problems will require respiratory compensation and this occurs rapidly - eg, by increasing ventilation to blow off CO2. Need to renew your license soon? Question 1. ph < 7.35 7.35-7.45 > 7.45. If a patient is expected to be on a ventilator for an extended period of time, an arterial line is typically placed to avoid repeated painful arterial sticks. These may include concern for: An Arterial Blood Gas requires the nurse to collect a small sample of blood - generally, a full 1 ml³ is preferred. Interpreting an arterial blood gas (ABG) is a crucial skill for physicians, nurses, respiratory therapists, and other health care personnel. Thank you, {{form.email}}, for signing up. Uses, Side Effects, Procedure, Results. An ABG looks at five different components of arterial blood: Interpreting ABG results is a complex process and requires strong clinical skills in order to take into account an individual's overall condition. Something as simple as vomiting can change the results, just as a serious or life-threatening lung condition can cause a change in ABG tests. Once the blood is obtained, it is either sent to the hospital’s central lab for analysis or tested by the respiratory therapist on the unit’s blood gas analyzer. ABG (Arterial Blood Gas) Practice Quiz This ABG practice test will examine your knowledge about respiratory and metabolic disorders when interpreting lab values. You can check it out at geekyquiz.com. 1. Calc Function ; Calcs that help predict probability of a disease Diagnosis. This enables staff to know if the ventilator settings are appropriate for the patient. There are six key components to an ABG. Partial Pressure of Carbon Dioxide (PaCO2), Understanding the Partial Pressure of Oxygen (PaO2) Test. Question 1. In the hospital setting, these results are used to make changes to the settings on a ventilator or to determine if a patient needs respiratory support with a ventilator or oxygen. Normal Values in ABG Interpretation PA – pressure in the alveoli Pa – pressure in the artery To convert kPa to mmHg, multiply by 7.5PaCO2 gives an indication of ventilation – how was is the patient breathing, how is their gas exchange Your healthcare provider should be able to tell you if the results were as expected and if the results indicate the patient is improving or needs more oxygen or even the support of a ventilator. The ABG is one of the most commonly performed tests before surgery, particularly in patients who have or are suspected to have breathing issues or lung disease. A value outside of the normal range (-2 to +2 mEq/L) suggests a metabolic cause for the acidosis or alkalosis. It is the dedication of healthcare workers that will lead us through this crisis. COVID-19 Resource Center . While arterial samples are the best for diagnostic reasons, they do provide some challenges for nurses and providers. close The pH is normal, so it is fully compensated. The radial artery on the wrist is most commonly used to obtain the sample. Simple Method of Acid Base Balance Interpretation A FOUR STEP METHOD FOR INTERPRETATION OF ABGS. 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. 6 Easiest Steps of ABGs interpretation. A base excess more than +2 mEq/L indicates a metabolic alkalosis. More ABG Examples. ABG interpretation is especially important in critically ill patients. Factors relating to sampling technique, specimen processing and environment may also influence the results. In terms of basic interpretation. ABGs are drawn for a variety of reasons. Steps in ABG analysis using the tic-tac-toe method. Understanding and use of blood gas analysis enables providers to interpret respiratory, circulatory and metabolic disorders. And even with a normal pH level, acidosis or alkalosis may still be present, as the body can compensate to … There are many different ways to remember how to analyze arterial blood gas. Get the latest updates on our Conferences PLUS our Webcasts and Education Newsletters. Memorize the normal values. Lab values: pH 7.56, paCo2 20, HCO3 20 * 2. The real value of an ABG comes from its ability to provide a near-immediate reflection of the physiology of your patient, … If a provider is not available to perform the arterial stick, treatment could be delayed. Interpreting ABG is not a difficult thing, it's actually very easy. Lab values: pH 7.31, paCo2 34, HCO3 21 * 4. Arterial Blood Gas (ABG) values: Anion Gap values: pH : 7.36 - 7.44 Sodium (Na +): mEq/L P CO 2: mm Hg 36 - 44 mm Hg: Bicarbonate (HCO 3-): mEq/L HCO 3-: mEq/L 22 - 26 mEq/L: Chloride (Cl-): mEq/L Albumin : g/dL Acid-Base Interpretation: Anion Gap : mEq/L Normal : < 16 ABG Quiz Practice Questions. A VBG on the other hand, tests the venous blood and can accurately determine pH and CO2 but is unable to provide reliable O2 data. However, the femoral artery and brachial artery can be used if necessary. Check out our favorite free online CEU courses. 1. Asking the help of more senior clinical nurses and respiratory therapists will allow novice nurses to master this skill. However, it's a crucial skill for nurses, physicians, respiratory therapists, and nursing students to learn. Join John Serginson for this relevant and informative discussion on the basics of ABG interpretation. Interpretation of Arterial Blood Gases (ABGs) - David A. Kaufman, MD. Base excess is defined as the amount of strong acid that must be added to each liter of fully oxygenated blood to return the pH to 7.40 at a temperature of 37°C and a pCO 2 of 40 mmHg (5.3 kPa). Results may include: Your healthcare provider should be … Register Now: Emcore Learn More. Clin Med (Lond). Thank you for everything you do. A pH of less than 7.35 indicates … Check. Blood gas sample data allow the reader to practice ABG interpretation. An ABG is a type of blood test that is taken from an artery, most commonly with a small syringe and an orange needle. equally, but do you know which nurses are making the most money in 2020? Introduction. If the pH < 7.35, then the patient is acidosis.⁵ Remember, the lower the pH number, the higher the acid level in the body. This method is simple, easy and can be used for the majority of ABGs. What You Need to Know About Interstitial Lung Disease. If a patient’s pH > 7.45, the patient is in alkalosis. This guide will focus on a commonly used seven-step process, which helps ensure a complete interpretation of every ABG. Table 1⇓ shows the results. For best understanding Youtube videos also available. We need to keep these goals in mind as they’ll come up later in the steps for the ABG interpretation technique. After the blood is drawn, pressure may be held on the site for five minutes or longer to prevent bleeding from the artery. 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. [3] Arterial blood gases made easy. So this article will break it down in a few simple explanations. Below are the terms used to label abnormal ABG results: Respiratory Acidosis (uncompensated, partially compensated, or fully compensated) Respiratory Alkalosis (uncompensated, partially compensated, or fully compensated) Metabolic Acidosis (uncompensated, partially compensated, or fully compensated) Subscribe to Resus. How to Interpret an ABG. Arterial blood gas (ABG) analysis is a crucial skill for perioperative nurses, in particular the RN circulator. Additionally, the arterial line allows for very accurate blood pressure monitoring that is continuous. These disorders are termed complex acid-base or mixed disorders. This can be achieved by buffer mechanisms which can be either renal or respiratory in nature. Arterial Blood Gas(ABG) Interpretation, Fully Compensation, Partial compensation, Causes & Treatment with example. Burns GP. A good refresher for all health professionals involved in the collection and interpretation of blood gas results. Interpretation of an arterial blood gas result should not be done without considering the clinical findings.The results change as the body compensates for the underlying problem. If you need a refresher on ABG interpretation then make sure to check out our guide. You are called to see a 54 year old lady on the ward. Email * We respect your privacy; Comments. The test results are used by medical professionals to assess how well oxygen is being distributed throughout the body and how well carbon dioxide is being removed. Physiology, Respiratory Alkalosis - Joshua E. Brinkman; Sandeep Sharma, 6. When interpreting ABG results, it is essential to know what ABG values are considered ‘normal’. Interpreting ABG results is a complex process and requires strong clinical skills in order to take into account an individual's overall condition. For this reason, arterial testing has become the gold standard in sick patients who are at risk for sudden decompensation or those with a respiratory component. Arterial Blood Gases (ABG) can be difficult and confusing to understand at first. This article provides the physiological basis for assessing ABGs perioperatively and presents a systematic approach to blood gas analysis using the Romanski method. Use pH to determine Acidosis or Alkalosis. Acidosis Normal or Compensated. *This table is able to classify most clinical blood gas values but not all. 1. We’ve recently released a new free quiz platform, which includes these scenarios and over 2000 other free MCQs. A "blood gas analysis" can be performed on blood obtained from anywhere in the circulatory system (artery, vein, or capillary). Recent studies suggest that the α-stat method is superior. Partial compensation means that the pH is still abnormal. Mistakes in arterial blood gas (ABG) interpretation are common in clinical practice. It is important to adopt a systematic approach to interpreting results of arterial blood gases, as outlined in table 2⇓, preceded by a brief history and focused clinical examination. This test is commonly performed in the ICU and ER setting; however, ABGs can be drawn on any patient on any floor depending on their diagnosis. If a patient’s pH > 7.45, the patient is in alkalosis. This is an unprecedented time. An arterial blood gas (ABG) specifically tests blood taken from an artery. What is an ABG? Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Full Name. In addition, provided is a … The main issue is if the patient does not have a functioning arterial line, a frontline clinician has to draw the arterial sample. Step 2. An arterial line allows for blood to be drawn from the artery without sticking the patient with a needle each time. Below are some brief clinical scenarios with ABG results. And it's FREE! This article has been reviewed by our panel of experienced registered nurses: 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.² The test is used to check the function of the patient’s lungs and how well they are able to move oxygen into the blood and remove carbon dioxide. Arterial blood gas (ABG) interpretation is something that can be difficult to grasp initially (we’ve been there). It is used to see how well the lungs are functioning and to determine the effectiveness of respiratory therapies, such as the use of a ventilator, CPAP, BiPAP, or oxygen. We’ve created this guide, which aims to provide a structured approach to ABG interpretation whilst also increasing your understanding of each result’s relevance. There’s a wealth of information available for nurses seeking to deepen their understanding of this important test. Respiratory Opposite -- In respiratory disorders, the pH and CO2 arrows move in opposite directions. There are two ways to draw an ABG: an arterial line (a special type of IV line that is placed into an artery that allows arterial blood to be drawn without a needle as often as is needed while the line is in place) or a needle and syringe to draw blood from an artery a single time. Try to interpret each ABG and formulate a differential diagnosis before looking at the answer. Scott Sundick, MD, is a board-certified vascular and endovascular surgeon. Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. Interpreting an ABG is a crucial skill for health care professionals, and it is especially important in critically ill patients. pH, PaCO2; HCO3-Step 1. Read the full article to gain a complete idea about ABG Interpretation. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. According to the National Institute of Health, typical normal values are: The first value a nurse should look at is the pH to determine if the patient is in the normal range, above, or below. When interpreting the ABG results, one must first know the five major components of the ABG to be addressed: oxygen saturation (SaO 2), partial pressure of oxygen (PaO 2), acidity or alkalinity (pH), partial pressure of carbon dioxide (PaCO 2), and bicarbonate ions concentration (HCO 3). Results may include: An arterial blood gas can be a very useful test, but the interpretation of this information is best left to the professionals. Something as simple as vomiting can change the results, just as a serious or life-threatening lung condition can cause a change in ABG tests. An Arterial Blood Gas, or ABG for short, is a test that measures the blood levels of oxygen (PaO2), carbon dioxide (PaCO2), and acid-base balance (pH) in the body. Interpreting the results ABGs can be interpreted using a stepped approach: Step 1 — check the pH The pH should be assessed first. Below is a chart that contains the different values and determining if the cause is respiratory or metabolic-driven, and if, to what degree, the patient is compensating for the pH. If the patient already has a pre-existing arterial line, this can be used to obtain the sample⁴. Most ICUs have one on the unit for a quick turnaround. These results are usually available for interpretation within five minutes. An arterial blood gas test, commonly known as an ABG, is performed on blood that is drawn from an artery. An arterial blood draw is more painful than a typical venous blood draw and is usually performed on the wrist or the groin. close The pH is normal, so either things are normal, or … Try to interpret each ABG and formulate a differential diagnosis before looking at the answer. It only addresses acid-base balance and considers just 3 values. Blood can be drawn via an arterial stick from the wrist, groin, or above the elbow. Read about the top student loan forgiveness programs for nurses and find out if you qualify. On the other hand respiratory problems leading to acid-base abnormalities require renal compensation. Results that would be alarming for one patient could be normal for another, and these test results can vary widely from hour to hour based on respiratory interventions that include providing oxygen or ventilator settings. They include: The aforementioned components all have different normal values and represent different aspects of the blood gas. In this video Nursing Professor Alice Benjamin, APRN, MSN, ACNS-BC, FNP, discusses Arterial Blood Gases and asks live questions. MINT Merch: https://teespring.com/stores/mint-nursing (Thank you for the support)Hey Guys!You are watching an educational video about interpreting ABGs. In the hospital setting, these results are used to make changes to the settings on a ventilator or to determine if a patient needs respiratory support with a ventilator or oxygen. A 21 year old man is brought in by his father with a one week history of vomiting. A base excess less than -2 mEq/L indicates a metabolic acidosis. Copyright © 2021 Full Beaker, Inc | 866-302-3888 | [email protected] | Do Not Sell My Personal Information, 4 Steps to Becoming a Labor and Delivery Nurse, National Center for Biotechnology Information, Journal of Clinical and Diagnostic Research, Physiology, Respiratory Alkalosis - Joshua E. Brinkman; Sandeep Sharma, Interpretation of Arterial Blood Gases (ABGs) - David A. Kaufman, MD, Kathleen Coduvell Gaines, BSN, RN, BA, CBC, Chronic Obstructive Pulmonary Disease (COPD), To check if lung condition treatments are working, Partial pressure of carbon dioxide (PaCO2). Next, examine the PaCO2. Blood pH has to be maintained within a tight normal range to avoid cellular death. It’s a nurse’s responsibility to be able to identify key components in order to be prepared for the next step. Before learning how to analyze an ABG, it’s important to understand what exactly it is, the different components and their corresponding values, and how it differs from a Venous Blood Gas (VBG). This article provides a collection of different ABG interpretation scenarios for you to work through. Lab values: pH 7.50, paCo2 32, HCO3 24 * 5. … Metabolic Equal -- In metabolic disorders, the PH and CO2 arrows will move in the same direction. How to Interpret Blood Gas Results: 10 Steps (with Pictures) The first value is the pH, which measures … Alkalosis. National Center for Biotechnology Information, 3. 2014;14(1):66-8. doi:10.7861/clinmedicine.14-1-66, Arterial Blood Gas (ABG) Testing and Results, Ⓒ 2021 About, Inc. (Dotdash) — All rights reserved. Despite their popular use, a lot of nurses still struggle to interpret an ABG. Acidosis. You Are Having a Troponin Test, What Is a Cardiac BNP Test? A blood gas may also reveal the presence of kidney problems, but is not typically performed to diagnose problems with the kidneys. There are eight (8) steps simple steps you need to know if you want to interpret arterial blood gases (ABGs) results using the tic-tac-toe technique. Journal of Clinical and Diagnostic Research, 5. Normally, healthy lungs … Is There Racial Bias in COVID-19 Detection? An ABG is one of the most commonly used tests to measure oxygenation and blood acid levels, two important measures¹  of a patient’s clinical status and correct interpretation can lead to quicker and more accurate changes in the plan of care. Two methods have been used in medicine in the management of blood gases of patients in hypothermia: pH-stat method and alpha-stat method. From this baseline, you can then begin to recognise significant variations in a patient’s results, which could indicate clinical deterioration. She is three days post-cholecystectomy and has been complaining of shortness of breath. And even with a normal pH level, acidosis or alkalosis may still be present, as the body can compensate to balance the pH.⁶. This field is for validation purposes and should be left unchanged. American Thoracic Society: Interpretation of ABGs, 1. This short and sharp presentation will refresh your knowledge and skills on how to interpret an Arterial Blood Gas result. The following six-step process helps ensure a complete interpretation of every ABG. This will enable the medical team to treat the patient adequately. Alkalosis. For example ABG's with an alkalemic pH may exhibit respiratory acidosis and metabolic alkalosis. The following is a simplified explanation of ABGs, including a practical method for interpreting results. The bicarbonate concentration is also calculated. close. This is slow and may need secretion of H+ ions or reabsorption/new production of HCO3- ions. … The first value a nurse should look at is the pH to determine if the patient is in the normal range, above, or below. Read our, Medically reviewed by Mark L. Meyer, MD, JD, Medically reviewed by Yasmine S. Ali, MD, MSCI, Medically reviewed by Douglas A. Nelson, MD, How to Perform an Arterial Blood Gas Test, Components Evaluated by Arterial Blood Gas Tests, Understanding Common Blood Tests and What They Mean, Definition of Arterial Blood Gases (ABGs), The Use of Noninvasive Positive Pressure Ventilation (NPPV), When to Expect Whenn. She has experience in primary care and hospital medicine. How Does Respiratory Acidosis Affect Breathing and Lead to Coma? 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