blood gas sampling

Indications for blood gas sampling

Need to evaluate ventilation and oxygenation, to assess patients response to therapy, to monitor severity and progression of disease process

Procedure of BGS

Check the order, check if on anticoagulants, pick puncture site, test for collateral circulation

Why is ice needed for the arterial blood sample

To stop metabolism

How much blood is needed for abg

1cc

How to test for collateral circulation

Modified Allen test

Modified Allen test

Touch radial and ulnar arteries, have patient make a fist, raise the arm for 5 seconds, lower the arm and release ulnar. Palm should flush within 5-10 seconds

Equipment for BGS

Patient label, ice, biohazard bag, PPE, ABG kit (syringe/needle, alcohol and gauze, needle guard, syringe cap)

ABG procedure method

Position wrist at 30* angle, clean site, touch, hold needle/syringe at 45* angle, when done apply pressure with gauze for 3-5 minutes. Remove air from syringe and mix it with heparin and transport

PaO2 in oxygenation

Pressure of oxygen in the plasma

SaO2 in oxygenation

Saturated of the Hb in a precent

PaCO2 in acid base

Pressure of carbon dioxide in plasma

HCO3

Bicarbonate

B.E

Base excess, used in calculations

Normal PaO2

80-100mmHg

Normal SaO2

93%-97%

Normal PaCO2

35-45mmhg

Normal ph

7.35-7.45

Normal HCO3

22-26mEq/L

Normal B.E

➕➖2

What is ph

Physiological mechanisms that keep the hydrogen concentration of body fluids in a range that is compatible with life

What regulates bicarbonate

Kidneys. By retaining or excreting amounts of hydrogen

What does a abnormal HCO3 imply

Metabolic involvement

What does a abnormal PaCO2 imply

Respiratory involvement

Types of compensation

Compensated, uncompensated, partially compensated, mixed disorder

Uncompensated

Ph and causative value are abnormal. Noncausative value is normal.

(Ex-ph 7.3, PaCO2 48, HCO3 24)

Compensated

Normal ph, causative and non causative values are abnormal

Partially compensated

Everything is abnormal, non causative value is compensating

Ex- ph 7.25, PaCO2 55, HCO3 15

Mixed disorder

All are abnormal with no compensation

SpO2

Non invasive read of oxyhemoglobin on the pulse oximeter

Hyperventilation

Low co2

Hypoventilation

High co2

Hyperexemia

High o2

Hypoxemia

Low O2