Arterial blood gases abg cardiovascular osce skills. The information given here supplements that given in chapters 2 and 3. Be able to demonstrate the technique for performing an arterial puncture. The operator should have all the required equipment at the bedside before beginning the procedure. How to take an arterial blood gas abg osce guide geeky. Clear, tolerating an oropharyngeal airway, on 40% oxygen via face mask b. Differences are subtle but important on venous gas. The body normally extracts 25% of available oxygen and leaves 75% in reserve in times of stress or illness. This is particularly important if your patient is known to have chronic respiratory disease with existing chronic abg changes.
Arterial blood gas abg interpretation for medical students. The definitive version is held on insite documents. Some blood gas analyzers also measure the methemoglobin, carboxyhemoglobin, and hemoglobin levels. Patient body temperature patient name, date of birth and hospital number if the patient is on oxygen therapy, the % concentration of oxygen given is required document the procedure in the patients notes, stating the rationale for the test, when the test was performed. The health professional taking a sample of your blood will.
Arterial blood gases after coronary artery bypass surgery article pdf available in chest 1025. Arterial blood gas sampling provides valuable information regarding respiratory function and acidbase status. Arterial blood gas determinations of pco2 provide the most accurate determinations of the adequacy of alveolar ventilation, but capillary, transcutaneous, and end tidal techniques are also useful. Sop for the measurement of arterial blood gas, electrolytes and haemoglobin derivatives using the roche cobas b221 blood gas analyser reference no. It is a fundamental skill that all medical trainees need to acquire. A blood gas test measures the amount of oxygen and carbon dioxide in the blood. During most blood testing procedures, blood is drawn from a vein. It is also useful to have access to any previous gases. Correct blood sampling for blood gas analysis ncbi. Collect 2ml arterialvenous blood in this heparinised syringe filling. This test is used to examine how well your lungs are able to move oxygen into the blood and remove carbon dioxide from the blood. Components of the arterial blood gas the arterial blood gas provides the following values.
Stability of po2, pco2, and ph in fresh blood samples stored in a plastic syringe with low heparin in relation to various blood gas and hemotological parameters. Standard operating procedure for the measurement of blood. Pdf arterial blood gases abg results reflect underlying pathology and. Blood gas values mixed venous gases measures oxygen left in the blood as it returns to the heart right side after it has been pumped around the body supplying cells with oxygen. Arterial blood bas abg procedure and interpretation slideshare.
Standard operating procedure for providing a rapid measurement of blood gas, electrolytes and haemoglobin derivatives at the point of care using the roche cobas b221 blood gas analyser document statement. The chief indication for blood gas analysis is the. Mar 27, 2012 the blood sample is collected and tested in a laboratory. Oct 15, 2017 an arterial blood gas abg test measures the acidity ph and the levels of oxygen and co2 in the blood from an artery. Arterial blood gas sampling via radial artery in adults guideline. Acidbase balance overview the ph is a measurement of the acidity or alkalinity of the blood. Jul 01, 2019 a blood gas test measures the amount of oxygen and carbon dioxide in the blood. Most contraindications are relative and rarely encountered. Arterial blood bas abg procedure and interpretation. Blood is drawn anaerobically from a peripheral artery radial, brachial, femoral, or dorsalis pedis via a single percutaneous needle puncture, or from an indwelling arterial cannula or catheter for multiple samples. User competencies should be documented in their personnel file.
Fresh whole blood collected in a lithium heparinized plastic syringe minimum draw 0. Arterial puncture for blood gas analysis nejm youtube. Sep 11, 2009 abgs made easy for nurses w tic tac toe method for arterial blood gas interpretation duration. It may also be used to determine the ph of the blood, or how acidic. Arterial blood gases values normal ranges and procedure. Pdf arterial blood gases after coronary artery bypass.
Clinical and laboratory standards institute, 940 west valley road, suite 1400, wayne, pennsylvania 190871898, usa. Withdraws 23 cc of blood fluid from arterial line first drop of blood with alcohol swab 11. Arterial blood gas analysis workshop case study 1 initial information i ed staff member has asked you to assist. Users of these guidelines should read chapters 2 and 3 before reading the information given below. Arterial blood gas analysis nursing standard analysis, including the types of tests, expected results, sampling, nursing considerations, and acidbase describe at least 6 factors that can interfere with arterial blood gas values. An arterial blood gas abg test will not be done on an arm used for dialysis or if there is an infection or inflammation in the area of the puncture site. Aarc clinical practice guideline blood gas analysis and. Arterial blood sampling who guidelines on drawing blood. Arterial blood has been widely recommended for use in blood gas studies because it accurately reflects acid base. Shares3\lab\poct\ procedurespoc current \ istat procedure rev.
Blood gas analysis competency statement the nurse safely and effectively performs and interprets the analysis of a blood gas specimen competency elements k 1. Arterial blood gas abg sampling is a commonly performed procedure which allows healthcare professionals to quickly obtain information on a patients respiratory status blood oxygen and carbon dioxide levels, as well as the patients acidbase balance. Remember there is always the other arm where the test could be performed. An arterial blood gas abg is a test that measures the oxygen tension pao 2, carbon dioxide tension paco 2, acidity ph, oxyhemoglobin saturation sao 2, and bicarbonate hco 3 concentration in arterial blood. Arterial blood gas analysis is widely available in hospitals. Arterial puncture blood gas gundersen health system. May 23, 20 consider doing a venous gas much of the important blood gas information can be elicited from a venous blood gas and it is much less painful if you are going to do a blood gas dont have multiple attempts in the same spot if you initially fail either get someone else to try or consider trying the femoral artery, brachial artery or. Jan 21, 2016 the blood gas analyser will require the following information. Blood gas analysis bga is almost a routine test in patients. List the values typically measured by a standard blood gas analyzer list the values typically measure by a cooximeter describe the various quality control measures used to assure the accuracy of blood gas values, including leveyjennings data. It is usually performed via a puncture of the radial artery at the wrist or the femoral artery at the groin.
This method is followed in rural hospitals which do not have their own lab. Preanalytical errors in blood gas testing radiometer. Know some of the indications and contraindications for performing an arterial puncture. Arterial blood specimen is the first choice for bga for assessing. Arterial blood has been widely recommended for use in blood gas studies because it accurately reflects acidbase. Indications puncture of the radial artery is the preferred method of obtaining an arterial blood sample for blood gas analysis. This chapter covers background information section 5. Abgs made easy for nurses w tic tac toe method for arterial blood gas interpretation duration. May 08, 2020 healthcare personnel should wear gloves and eye protection for the duration of the arterial blood gas abg sampling procedure and should follow hospital policies regarding management of body fluid samples. Discard the first drop of blood which has been exposed to air. Arterial blood gas analysis can be used to assess gas exchange and acid base status as well as to provide immediate information about electrolytes. A procedure called the allen test may be done to ensure that blood flow to your hand is normal. May 26, 2018 an arterial blood gas abg is a blood test carried out by taking blood from an artery, rather than a vein.
It is a fundamental skill that all medical trainees need to. Interpret the oxygenation state of a patient using the reported arterial blood gas pao2 value. Interpret the results of various arterial blood gas samples. Blood gas and ph analysis and related measurements. B she was thrown from her horse at a local event a a. Blood gas analysis bga is almost a routine test in patients admitted in. Identify the following components measured in arterial blood gas analysis and state their normal ranges. Arterial puncture for blood gas analysis overview radial arterial puncture for arterial blood gas analysis is a common procedure performed in medicine. And since it is an emergency, one has to be really quick in sending one. The best way to be certain that a specimen is arterial is if the blood pulses into the syringe or by noting the pao 2 value from the lab. However, this may not be possible in certain clinical scenarios, such as a critically ill patient with rapid decompensation or a patient with an altered level of consciousness eg. We may be presented increasingly with venous blood gases 2. The procedure, called the modified allen test, checks that blood flow to your hand is normal.
Describe at a normal level with co2 at standard value. Gently squeezes finger heel and obtains blood sample 12. The trust will ensure that the risk to patients undergoing point of care. Radial arterial puncture for arterial blood gas analysis is a common procedure per formed in adults. Cord blood gas sampling procedure purpose the purpose of this guideline is to provide safe and effective care for women establish a local approach to care, that is evidence based and consistent inform good decision making scope obstetric staff employed by the hutt valley dhb. This flushing of the entire hand documents that the ulnar. Connects abg syringe, opens stopcock, and obtains in capillary tube blood gas sample 1 cc 11. Radial arterial puncture for arterial blood gas analysis is a common procedure performed in adults. Arterial blood gas abg sampling oxford medical education. Closes 3way stopcock to port and removes syringe 10. S 21yearold woman who on the way to hospital has become increasingly drowsy. Dec 05, 2014 abgs made easy for nurses w tic tac toe method for arterial blood gas interpretation duration. Discusses procedure with patient i obtains consent.
After specimen has been obtained, mix sample by rolling syringe between palms for at least 5 seconds then inverting the syringe repeatedly for at least 5 seconds. It is performed so that an accurate measurement of oxygen and carbon dioxide levels can be obtained, which then allows the patients oxygen to be delivered appropriately. Contraindications to performing ph blood gas analysis and hemoximetry include. It is performed on patients in respiratory distress, such as an. Follow usual anaerobic procedure for drawing blood gases. Compress the radial and ulnar arteries while patient is clenching the hand lower hand and have patient relax the arm to alleviate tension which can cause inaccurate results release pressure on the ulnar artery and observe for brisk return of color to the hand 8. Arterial, venous, or capillary blood gas analysis is an important diagnostic. It may also be used to determine the ph of the blood, or how acidic it is. Decide whether to proceed with the test if a contraindication is present on the basis of how urgent the sample is. Neonatal pediatric arterial puncture 052118 formulated.
By interpreting arterial blood gases test results, doctors can determine the state of the bodys lung and kidney function. In order to prepare for an arterial blood gas test, tell your doctor about all medications. Identify the relationship between oxygen saturation and pao2 as it relates to the oxyhemoglobin dissociation curve. May 08, 2020 healthcare personnel should explain the arterial blood gas abg sampling procedure to the patient, with particular attention to the associated risks and benefits. As blood goes through your lungs, oxygen relocations into the blood while co2 moves out of the.371 633 1611 903 1434 265 1400 5 1332 1539 27 670 1037 1273 48 194 1619 1242 619 389 1053 1590 499 1501 116 146 1388 1571 805 990 542 950 1593 1627 582 687 477 432 1080 1326 1187 1052