ABG Analysis ppt

ABG Analysis ppt

1. ABG ANALYSIS : NURSES ROLE PRESENTED BY: PROF.VIJAYREDDY PhD Scholar, M.Sc (N), PGDHA, PGCDE,. DEPT OF MEDICAL-SURGICAL NURSING INDIA.

2. INTRODUCTION: Interpreting an arterial blood gas (ABG) is a crucial skill for Physicians , Nurses , Respiratory Therapists , and other health care personnel. ABG interpretation is especially important in critically ill patients . The following six-step process helps ensure a complete interpretation of every ABG. In addition, you will find tables that list commonly encountered acid-base disorders . Many methods exist to guide the interpretation of the ABG. This discussion does not include some methods, such as analysis of base excess or Stewart’s strong ion difference. A summary of these techniques can be found in some of the suggested articles. It is unclear whether these alternate methods offer clinically important advantages over the presented approach, which is based on the “anion gap.”

3. WHAT IS AN ARTERIAL BLOOD GAS TEST? An arterial blood gas (ABG) test measures oxygen and carbon dioxide levels in   blood . It also measures body’s acid-base (pH) level, which is normally balanced when healthy .

4. OBJECTIVES: 1.Understand ABG and its terms 2.Know some of the indications and contraindications for performing an arterial puncture. 3.Be able to demonstrate the technique for performing an arterial puncture.

5. COMMON TERMS • PCO2 (ventilation) – Partial Carbon Dioxide • PaO2 - (oxygenation) –Partial Oxygen • HCO3 – (metabolism) -Bicarbonate • O2Sat – Oxygen Saturation • pH – Acid/Base balance • BE – Base excess

6. NORMAL ABG VALUES

7. INDICATIONS • Assess the ventilatory status, oxygenation and acid base status . • Assess the response to an intervention. • Regulate electrolyte therapy. • Establish preoperative baseline parameters.

8. Arterial blood gas test results may show whether: Your lungs are getting enough oxygen Your lungs are removing enough carbon dioxide Your  kidneys  are working properly

9. B lood draw points for ABG analysis

10. EQUIPMENTS Arterial blood gas syringe Needles (20, 23 and 25 gauge, of different lengths) Alcohol wipe –  70% isopropyl  Gauze Tape Lidocaine – with small needle/syringe for administration Sharps container Gloves Apron

11. PROCEDURE Local anesthetic The sample is routinely obtained from the radial artery and it is recognized that that the procedure causes significant pain for the patient and that this can be markedly reduced by the use of subcutaneous local anesthetic.

12. PREPARATION 1 . Position the patient’s arm preferably on a pillow for comfort with the wrist extended (20-30°)  2. Prepare all the equipment in the equipment tray using an aseptic non touch technique 3. Palpate the radial artery on the patient’s non-dominant hand (most pulsatile over the lateral anterior aspect of the wrist) 4. Clean the site with an alcohol wipe for 30 seconds and allow to dry before proceeding  5. Wash hands again 6. Don gloves and apron 7. Prepare and administer lidocaine subcutaneously over the planned puncture site ( aspirate to ensure you are not in a blood vessel before injecting the local anesthetic). 8. Allow at least 60 seconds for the local anesthetic to work  9. Attach the needle to the ABG syringe, expel the heparin and pull the syringe plunger to the required fill level (check with your local laboratory)

13. Taking the sample 1 . Palpate the radial artery with your non-dominant hand’s index finger around 1cm proximal to the planned puncture site (avoiding directly touching the planned puncture site that you have just cleaned) 2. Warn the patient you are going to insert the needle 3. Holding the ABG syringe like a dart insert the ABG needle through the skin at an angle of 45° over the point of maximal radial artery pulsation (which you identified during palpation) 4. Advance the needle into the radial artery until you observe blood flashback into the ABG syringe 5. The syringe should then begin to self-fill in a pulsatile manner (do not pull back the syringe plunger)

14. CONTD…. 6. Once the required amount of blood has been collected remove the needle and apply immediate firm pressure over the puncture site with some gauze 7. Engage the needle safety guard  8. Remove the ABG needle from the syringe and discard safely into a sharps bin 9. Place a cap onto the ABG syringe and label the sample 10. Yourself or a colleague should continue to apply firm pressure for 3-5 minutes to reduce the risk of  hematoma formation

15. To complete the procedure Dress the puncture site Thank the patient Dispose gloves and equipment into an appropriate clinical waste bin Wash hands Take the ABG sample to be analysed as soon as possible after being taken as delays longer than 10 minutes can affect the accuracy of results

16. Complications related to ABG sampling A rteriospasm  Hematoma  N erve damage  F ainting  O ther problems can include a drop in blood pressure, complaints of feeling faint, sweating or pallor that may precede a loss of consciousness.

17. THANK YOU