ABG slidshare
- 1. AB G S U B M I T T E D B Y : K H A L I D A . A L - H A R B I .
- 2. What IS ABG ? - Arterial Blood Gasses *the purpose of collecting ABG ? - To measures the acidity (PH) and the levels of oxygen and carbon dioxide in.the blood from an artery
- 3. *WHAT ARE THE SITES BLOOD CAN BE DRAWN FOR BLOOD GAS ANALYSIS ? - Usually from peripheral art. (Radial, Brachial, Femoral or Dorsalis pedis) - Arterialised capillary sample. .- Rare cases venous blood is used
- 4. How arterialised capillary sample is taken * Site – Finger, toe, heel or ear lobe * Wrapping in warm pad (40-430 C) for 10 minutes * Massage ear lobe for 2-3 minutes * Heparinised capillary tube should be sealed after collecting sample with clay at one end •* Short steel wire is inserted then other end is sealed * Steel wire is moved with magnet to mix the sample
- 6. Procedure of ABG Sample Collection Prepare Collect Send to Lab
- 7. *WHAT IS THE DIFFERENCE BETWEEN : BLOOD GAS MONITORING & BLOOD GAS ANALYSIS ? - Blood gas monitor is a patient dedicated device that measures arterial pH, PaCO2 and PaO2without permanently removing blood. - For blood gas analysis – Blood is removed from Patient .
- 8. * BLOOD GAS ANALYSIS? - Acid-base status. .- Oxygenation
- 10. Blood Gas Norms pH pCO2 pO2 HCO3 BE Arterial 7.35-7.45 35-45 80-100 22-26 -2 to +2 Venous 7.30-7.40 43-50 ~45 22-26 -2 to +2
- 11. * What are indications & contraindications of arterial blood gas analysis ? Indications: - To evaluate the adequacy of ventilation - To Quantitate patient’s response to therapeutic intervention Contraindications: - -ve result of Allen’s test - Coagulopathy or medium to high dose anticoagulation therapy (Heparin, Coumadin, streptokinase, Caprostat) - Femoral puncture avoided outside hospital - Arterial puncture not performed distal to surgical shunt
- 12. * What are the complications of Arterial Puncture? - Arteriospasm, Haematoma, Emboli (Air or clotted blood), Anaphylaxis if LA is used, Haemorrhage, Trauma to vessel , Arterial occlusion, Vasovagal response and Pain
- 13. - PH in ABG? 1- Determine if pH is acidotic or alkalotic 2-Determine cause: A-Respiratory B-Metabolic C-Mixed 3. Check oxygenation
- 14. Acid-Base Regulation * Three mechanisms to maintain pH - Respiratory (CO2) - Buffer (in the blood: carbonic acid/bicarbonate, phosphate buffers, Hgb) - Renal (HCO3 -)
- 15. CO2 + H2O H2CO3 HCO3- + H+ Respiratory component Acid Blood/renal component Base Acid-Base Equation: the carbonic acid/bicarbonate - Every change in CO2 of 10 mEq/L causes pH to change by 0.08 (or Δ1 = 0.007) - Increased CO2 causes a decreases in pH - Decreased CO2 causes an increase in pH
- 16. Acid vs. Alkaline Blood pH Venous pH = 7.35 Arterial pH = 7.40 6.9 7.00 7.1 7.2 7.3 7.4 7.5 Acidosis Neutral pH Alkalosis
- 17. Respiratory Acidosis - Hypercarbia from hypoventilation Findings: -pCO2 increased therefore… pH decreases ---------Example:---------- ABG : 7.32
- 18. Respiratory Alkalosis -Hypercarbia from hypoventilation Findings: -pCO2 decreased… therefore pH increases --------------------Example: ABG – 7.45
- 19. Metabolic Changes -Remember normal HCO3 - is 22-26 Rule #2 Every change in HCO3 - of 10 mEq/L causes pH to change by 0.15 Increased HCO3 - causes an increase in pH Decreased HCO3 - causes a decrease in pH