Arterial blood gas abg analysis is a crucial skill for perioperative nurses, in particular the rn circulator. Here is the easiest way to interpret abg results using the tic tac toe method. If the pa co2 is less than 35 mm hg,more carbon dioxide is being exhaled than normal. Each case is then followed by an explanation of the acidbase status, the oxygenation status and a summary of the patients clinical picture. The use of abgs in acutely ill or deteriorating patients requires rapid and accurate interpretation. Arterial blood gases indications and interpretation. Analysis of blood gas can be a daunting task, but it is still one of the most. Blood gas sample data allow the reader to practice abg interpretation.
Co2 retention or you lost a lot of alkali higher alkalosis. Everyone can read an electrolyte level, but when faced with a list of abgs, most nurses wilt. The real value of an abg comes from its ability to provide a. However, the femoral artery and brachial artery can be used if necessary. Arterial blood gas interpretation, abg analysis, rules for rapid abg. Woodruff, msn, rnbc, cns, cen nurses often have difficulty interpreting arterial blood gases abgs. Arterial blood gas abg interpretation is something many medical students find difficult to grasp weve been there. The content of the open access version may differ from that of the licensed version. Below are some brief clinical scenarios with abg results. Blood can be drawn via an arterial stick from the wrist, groin, or above the elbow. Included with the worksheet are physiological reasons for abnormalities. How to interpret arterial blood gas results correspondence. This method is simple, easy and can be used for the majority of abgs. Confusion often begins with trying to remember many random rules and lacking a standardized approach to abgs.
Identify the relationship between oxygen saturation and pao2 as it relates to the oxyhemoglobin dissociation curve. Tic tac toe method arterial blood gas abg interpretation. Nursing exam cram sheet for the nclexrn the final mountain that nursing students must summit before becoming a registered nurse is the nclex. Interpret the oxygenation state of a patient using the reported arterial blood gas pao2 value. This video tutorial is on how to setup arterial blood gas problems using the tic tac toe method. This article provides the physiological basis for assessing abgs perioperatively and presents a systematic approach to blood gas analysis using the romanski method. The results of abg testing will often influence the treatment that patients receive. If the paco2 is greater than 45 mm hg,less carbon dioxide is being exhaled than. Arterial blood gas case questions and answers in the space that follows you will find a series of cases that include arterial blood gases. This tictactoe technique involves a few charts to help you visualize abgs. Your pt may need urgent oxygenation, and you dont want to wait around while you diddle around with interpreting the entire abg.
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. The processes that occur in the body drive this equation either to the left or to the right to maintain a normal ph. Abg analysis provides measurements for an array of parameters, so it can be confusing knowing where to start interpreting them. Interpretation of the arterial blood gas emergencypedia. A 55yearold man with communityacquired pneumonia was admitted to the icu for respiratory distress. However, the understanding of abgs and their interpretation can sometimes be. Identify components of an arterial blood gas abg and list normal ranges for each. Arterial blood gas abgs interpretation for nursing students and nurses. Paco 2 measures the partial pressure of carbon dioxide co 2 dissolved in arterial blood. But it is often encountered that many students dont know how to read abg, and thats. To check for compensatory, look at the result you didnt circle. Partial compensation means that the ph is still abnormal. Interpreting arterial blood gas values paco2 partial pressure of arterial carbon dioxide hco3 bicarbonate increase level decreased level n normal level step 4.
The real value of an abg comes from its ability to provide a nearimmediate reflection of the physiology of your patient, allowing you to recognise and treat pathology more rapidly. It only addresses acidbase balance and considers just 3 values. There are many creative ways to teach arterial blood gas interpretation. Developed specifically for student nurses and based on the authors over thirty years of teaching experience, interpreting arterial blood gases the easy way teaches students a stepbystep method for interpreting blood gases and helps them learn how to apply. Some of these nurses feel they will never use it in their job and feel it is the respiratory therapists job or. Determine the cause of the acidosis or alkalosis by looking at the pco2 and hco3if ph practical and easy approach 1. Determine the cause of the acidosis or alkalosis by looking at the pco2 and hco3if ph abgs to help you learn how to interpret with ease. Abgs made easy for nurses w tic tac toe method for. Example 6 31 year old aam took too many pills for suicide attempt na 9, k 5. Arterial blood gas abg interpretation for medical students, osces and mrcp paces this section presents how to interpret arterial blood gases. To see how to perform an arterial blood gas check out our guide here. A systematic approach to the interpretation of abg results step 1. Check the name and identification number on the report against the patients other records e.
The results of an abg test can be particularly helpful in any surgery in which large fluid shifts or blood loss are expected eg, bowel resection, whipple procedure, liver resection, thus providing information regarding the patients fluid status and metabolic state. If you want to put your abg interpretation skills to the test, check out our abg quiz. An arterial blood gas abg specifically tests blood taken from an artery. Fortunately, there are some easy ways to remember how to decipher these important lab results. Interpreting the information obtained from an abg result, combined with the patients history and our knowledge of normal pathophysiology as it applies to acidbase balance will help us to plan how to resolve the problem lippincott, 2012. Understanding and use of blood gas analysis enables providers to interpret. Jan 26, 2015 arterial blood gases abgs are an important routine investigation to monitor the acidbase balance of patients. Interpreting an arterial blood gas abg is a crucial skill for physicians, nurses, respiratory. Apr 03, 2020 an arterial blood gas requires the nurse to collect a small sample of blood generally, a full 1 ml.
The pao2 measures oxygenation, and normal ranges are 80100 mm hg. Interpreting abgs arterial blood gases made easy ausmed. Interpreting an arterial blood gas abg is a crucial skill for physicians, nurses, respiratory therapists, and other health care personnel. Renal compensation that is not complete for 35 days in acute.
Aug, 2018 easy way to interpret abg values in 7 simple steps overview of the 7 simple steps. Arterial blood gases abg can be difficult and confusing to understand at first. It explains each component in turn followed by clinical examples to work through. Arterial blood gas abg interpretation for medical students. By the completion, the reader will have the tools necessary to assess any abg that may be encountered in clinical practice. This is where this cram sheet can help it contains condensed facts about the licensure. Once youve mastered this technique, youll be doing actual abg interpretation. Interpreting blood gases, practical and easy approach. Pdf arterial blood gases abg results reflect underlying pathology and interpretation of the results are often compounded by ongoing. Easy way to interpret abg values in 7 simple steps overview of the 7 simple steps. Jul 24, 2017 3 easy steps for interpreting abgs date. Abgs are important to know and the best way to become familiar with them is to practice.
Handbook of blood gasacidbase interpretation springerlink. Weve created this guide, which aims to provide a structured approach to abg interpretation whilst also increasing your understanding of each results relevance. Abcs of abgs a guide to interpreting acid base disorders. The ability to accurately assess abgs allows the perioperative nurse to assist surgical team members in restoring a patients acid. There is an open access version for this licensed article that can be read free of charge and without license restrictions. When the ph is normal, it will be fully compensated. The most common location for obtaining an abg is the radial artery. Interpreting abgs practical approach muhammad asim rana bsc, mbbs, mrcp, sfccm, fccp, edic department of adult critical care medicine ksmc, riyadh 2. However, its a crucial skill for nurses, physicians, respiratory therapists, and nursing students to learn.
Abg interpretation a guide to understanding abgs geeky medics. Interpreting arterial blood gases successfully larkin. If it has moved from the normal value in the opposite direction of those circled, compensation is occurring. Abg interpretation free download as powerpoint presentation. Abg interpretation a guide to understanding abgs geeky. Interpreting arterial blood gases successfully sciencedirect.
Blood gas interpretation can be useful in a wide variety of surgical procedures. If the patient is unstable, manual ventilation with a bag. May 06, 2015 abgs tic tac toe method for nurses with quiz. Try to interpret each abg and formulate a differential diagnosis before looking at the answer. If the abg results are abnormal, determine if the abnormality is due to the kidneys metabolic. Respiratory acidosis compensation occurs in 2 steps 1. Abg examples abg exam questions for medical students and. We dont only want to interpret abg values for fun, they have a very important purpose. They may help make a diagnosis, indicate the severity of a condition and help to assess treatment. Arterial blood gases abgs are used to monitor patients on ventilators, monitor critically ill nonventilator patients, establish preoperative baseline parameters and regulate electrolyte therapy.
The radial artery on the wrist is most commonly used to obtain the sample. Ryan barnes, bsn, rn, pccncsc 2 comments arterial blood gases abgs are used to monitor patients on ventilators, monitor critically ill nonventilator patients, establish preoperative baseline parameters and regulate electrolyte therapy. The partial pressure of oxygen dissolved in plasma. Interpreting arterial blood gases aorn fluid shifts during surgery, the interpretation of arterial blood gases abgs and correct intervention by the rn circulator and the anesthesia professional can. Identify one of the first signs of an acidbase imbalance. Therefore, a basic understanding of how to interpret abg results can be useful for pharmacists to help them clarify the clinical picture. Abg examples abg exam questions for medical students osces and mrcp paces. Without knowing them, your patient could easily go. Many new nurses feel they are not comfortable with interpreting abgs after they graduate. The most important points when assessing a patient are the history, examination and basic observations. Interpretation of arterial blood gases abgs david a. Beyond that, however, blood gas interpretation can seem like a mystery to many health professionals. Identify normal arterial blood gas values and interpret the meaning of abnormal values.
Abg interpretation steps to abg interpretation step 1. Monitoring of acidbase balance is done by testing patients arterial blood gases abgs. Hes also a member of the nursing2010 editorial board the author has disclosed that he has no financial relationships related to this article. Arterial blood gas interpretation 1 acidaemia or alkalaemia. Bill pruitt is the director of clinical education and a senior instructor in the department of cardiorespiratory sciences at the university of south alabamas college of allied health science in mobile, ala. 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. Cell buffering that acts within minutes to hours 2. Sep 27, 2015 arterial blood gas abg analysis is a crucial skill for perioperative nurses, in particular the rn circulator. Interpret the results of various arterial blood gas samples. 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. Prior to doing an abg at the radial artery, a modified allens test should be performed assessing for dual arterial supply to.
Indications, interpretations, and clinical applications m etabolic derangements and respiratory distress are common presenting problems in emergency medicine. Abgs made easy for nurses w tic tac toe method for arterial. This article illustrates the use of the stepwise approach, tables, figures, case studies, illustrations, computerbased learning modules, and the tictactoe approach. Interpreting and using the 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.
If the paco 2 is less than 35 mm hg, more carbon dioxide is being exhaled than normal and indicates alkalosis. Now lets look at two case scenarios to see how the fivestep approach see steps to interpreting abgs can help you interpret abgs and manage your patients condition. Interpretation of the arterial blood gas selflearning packet see swift for list of qualifying boards for continuing education hours. View enhanced pdf access article on wiley online library html view. Full compensation means that the ph is back to normal. Creative ways to teach arterial blood gas interpretation. Preparing for the nclex can be stressful as taking in colossal amounts of information has never been easy. Patients are often required to be checked for arterial blood gas analysis to find what exactly is happening in the body of patients system. Arterial blood gasses, or abgs, may be among the most complex and confusing parts of nursing practice. W e often encounter patients who are critically sick and need monitoring more than vitals like bp and pulse rate.
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