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Resp 13-14

Notes for ABG

What is an ABG it's oxygenated, draw from the artery-radial, bronchial, femoral....Helps differntiate oxygen defiencies from primary metabolic acid-base abnormalities
ABG cornerstone in the diagnosis and management of oxygenation (PaO2) and acid-base (pH and PaCO2) disturbances
PaO2 oxygen in arterial blood
Why do we need to know PaO2 to assess symptims of hypoxemia, determine parameters of oxygen, assess/titrate oxygen therapy, document need of oxygen reimbursment, and to assess/titrate ventilator parameters
Why need to know PaCO2 to assess/titrate ventilation, to assess symptoms of dyspnea, to determine deadspace ventilation
Why need to know pH & HO3 to asses acid/base balance, to categorize acid/base disturbances
Allen test test to the wrist checking for collateral blood flow through the ulnar
Normal results for allen test hand color flushes within 5-7 seconds
Alternative methods for checking for collateral blood flow doppler ultrasound, pulse oximeter
ABG contraindications negative allen test, no ABG through a lesion or distal to a surgical shunt (dialysis) and be caution with pt that take anticoagulants
Why choose radial artery? 1. near the surface and relatively easy to palpate and stabilize 2. collateral circulation, 3. artery is not near and large veins, 4. procedure is relatively pain free
What to label on the syringe date, time, pt name, O2 %, temp if abnormal, and your initials
Hazards of ABG infection, bleeding, and obstruction of the vessel
What to document in chart date, time, document puncture information, and verify sent to lab
What does blood gas analyzer directly measure pH (sanz electrode), PaCO2 (serveringhaus electrode), PaO2 (Clark electrode)
What does blood gas analyzer indirectly measure HCO3, O2 saturation (this is done by calculating from the directly measurements)
What does co-oximeter measure hemoglobin content and values related to hemoglobin binding: SaO2, % COHB , and % methemoglobin
What does the blood gas machine accuracy depend on 1.accurately measuring barometric pressure 2. properly calibrating machine-running measurements against known values 3. maintaining electrodes 4. running quality control procedures
Calculating Calibration (PB- PH2O) x fractional concentration of gas EX---- (760-47) x 10%CO2 = 71.3 mmHg
Created by: TnJFarrington12