ABG .pdf

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1. ABG
ءاعنص ةعماج
يحصلا مولعلاو بطلا ةيلكة
يلاع ضيرمت
فارشإ تحت:
د/ ىسومةيقفلا
د/ظيفح ماسب
د/ نادمغشاجب
بلاطلا دادعإ:
دمحم دمحادركم

2. Introduction:
ABG: stands for arterial blood gas, which is critical diagnostic
test used in medicine to assess patient’s respiratory and
metabolic status by analyzing the levels of oxygen, carbon
dioxide, pH and bicarbonate in the arterial blood.
It provides vital information about lung function, acid-bace
balance and oxygenation in the body.

3. Definition:
•ABG: diagnostic procedure using arterial blood to
assess oxygenation, Acid-base balance. It measures
partial pressure of O2(PaO2), Hb saturated with
oxygen (SaO2), partial pressure of CO2 (PaCO2), blood
pHand level of bicarbonate(HCO2) ions.

4. Indications
•To assess: respiratory Status.
•Assess oxygenation and ventilation
Acid-Base balance.
•Phlebotomy. Used if venous route is
unavailable or inaccessible due to
trauma or burns.
•Ventilated patients to evaluate
response to clinical intervention.
•Diagnostic –evaluation ( Oxygen
therapy).
•Any sever illness which lead to
metabolic acidosis or alkalosis:
For example:
DKA
Shock
Cardiac failure
Renal failure
Hyperglycemic status associated
with DM.
Burns
Poisons/toxins.

5. Sites Of ABG Puncture:
•Radial
•Brachial
•Femoral
Radial is the most preferable site used because:
Easy to access
It isn’t deep artery which facilitate palpation, stabilization and
puncturing
The artery has a collateral blood circulation.

6. Contraindications
•Local infection or burns at insertion site.
•Absent collateral circulation.
•Coagulopathy
•Distorted anatomy
•Raynaud’s disease; is intermittent arteriolar vasoconstriction
•Sever atherosclerosis
•Arteriovenous shunt.

7. Complications
•Bleeding causing local hematoma
•Arterial vasospasm
•Arterial occlusion
•Air or thrombus embolism
•Infection causing arteritis or cellulitis at the puncture
site.
•Numbness due to nerve injury
•Distal ischemia

8. Equipment
•Sterile Gloves
•Heparin
•Alcohol swab
•Lidocaine
•Arterial blood gas sampling kit. special kit with ice, the tube
place in it.
•2 –3cc syringe
•Tube to store sample
•2x2 cm gauze
•plaster

9. Allen’s test
It’s a test done to
determine that
collateral circulation is
present from the ulnar
artery in case
thrombosis occur in the
radial.

10. The procedure
•Record patient inspired oxygen concentration
•Check patient concentration
•Explain the procedure to the patient
•Provide privacy for client
•Collect materials, hand washing and apply gloves
•Palpate the artery for maximum pulsation
•If radial has pulse, preform Allen’s test
•Place a small towel roll under the patient wrist
•Instruct the patient to breath normally during the test and warn him
that may feel cramping or throbbing pain at the puncture site.
•Clean with alcholswab in circular motion

11. The procedure
•Skin and subcutaneous tissue may be infiltrated with local anesthetic
agent if needed.
•Insert needle at 45 radial 90 femoral.
•Collecting the appropriate amount of blood to the syringe.
•Withdraw the needle and apply digital pressure.
•Empty bubbles from syringe
•Empty the syringe to the tube immediately
•Tape the gauze in place
•Maintain firm pressure on the puncture site for 5 minutes, if patient
has coagulation abnormalities apply pressure for 10 –15 minutes.

12. The procedure
•Send specimen tube to the lab immediately
•Palpate the pulse distal to the puncture site.
•Assess for cold hands, numbness, tingling or
discoloration
•Documentation include: results of Allen’s test’
time the simple was drawn, temperature,
puncture site, time pressure was applied and if O2
therapy was there.

13. Note: Normal range for HCO3 = 24 –27 mEq/L according
to Brunner Textbook.

16. How to read the result of ABG?

17. Example 1
The result of ABG is normal

18. Example 2
The result of ABG is normal

19. Example 3
Uncompensated
Metabolic Acidosis

20. Example 4
Uncompensated
Respiratory Alkalosis

21. Example 5
Uncompensated
Respiratory Acidosis

22. Example 6
Uncompensated
Metabolic Alkalosis

23. Example 7
Partially Compensated
Respiratory Alkalosis

24. Example 8
Partially Compensated
Metabolic Acidosis

25. Example 9
Partially Compensated
Respiratory Acidosis

26. Example 10
Partially Compensated
Respiratory Alkalosis

27. Example 11
Fully compensated
Metabolic Acidosis

28. Example 12
Fully Compensated
Respiratory Acidosis

29. Example 13
Fully Compensated
Respiratory Alkalosis

30. Example 14
Fully compensated
Metabolic Alkalosis

31. Example 15
Mixed Metabolic &
Respiratory Acidosis

32. Example16
Mixed Metabolic &
respiratory Alkalosis

33. The End