The Basics of ABG for nursing students.pptx

This ppt is for nursing for learning the basics of ABG at nursing level

1. The Basics of Arterial Blood Gas (for nursing) Dr Surjeet Acharya Attending Consultant and Faculty Department of Emergency Medicine Max Hospital, Shalimar Bagh, New Delhi

2. Objective of the class Sites for ABG sampling in patients Processing of ABG sample (handling of ABG syringe and sample) Use of ABG in Emergency Department Describe the components of ABG - pH, pO2, pCO2, HCO3 Interpret sample ABG’s Compensation in ABG Summary

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4. Sites for ABG Sampling Radial Brachial Femoralrial Q. What is Allen Test?

5. Allen Test in ABG sampling

6. Handling ABG syringe BEST - heparinised ABG syringe NO RE-CAPPING 0.5ml of 1:1000 heparin should be flushed and emptied

7. Uses of ABG in the Emergency Medicine Department Analysis of acid-base status Aids in establishing the diagnosis Ventilator management Guides in the treatment plan Which patient need ABG? Patient with severe blood loss / hemorrhage Respiratory distress COPD, ARDS, Shock Cardiac Arrest Kidney failure / CKD / AKI Patient on ventilator

8. Human Body Physiology The hemostatic mechanism in the body maintains the body pH between 7.35-7.45 The buffer system in the body is maintained by kidneys and lungs The body tries to maintain the homeostasis by autroregulation of the organs (lungs and kidney)

9. Components In ABG pH: < 7.35 - Acidic >7.45 - Alkalosis

10. 2. pO2 - the pressure exerted by Oxygen in the body is called partial pressure of oxygen 3. pCO2- the pressure exerted by carbon dioxide in the body is called partial pressure of carbon dioxide 4. Bicarbonate (HCO3) - Cation element in the body that neutralizes the anion (positively charged) to maintain the neutral pH of the body.

11. Normal ABG values

12. Other components in the ABG report Electrolytes : a. Sodium (Na) : 135-145 mEq/L b. Potassium (K) : 3.5-5.5 mEq/L c. Chloride (Cl) : 100-110 mEq/L Haemoglobin (Hb) Lactate (Lac) : 0.0 - 2.0 Osmolality (mOsm) : 285-295 Glucose (Glu)

13. Examples 1. pH 7.14 pO2 85 pCO2 75 HCO3 24 RESPIRATORY ACIDOSIS Eg’s: Exacerbation of COPD CNS disorder

14. Examples contd.. 2. pH 7.20 pO2 75 pCO2 38 HCO3 16 Metabolic Acidosis Causes: Severe Diarrhoea TPN without bicarbonates Use of Diuretics

15. Examples contd.. 3. pH 7.52 pO2 88 pCO2 26 HCO3 22 Respiratory Alkalosis Causes: Hyperventilation like anxiety Salicylate overdose

16. Compensation in Acid Base disorder

17. Summary ABG interpretation plays crucial role in management of critically ill patients in the ED and ICU ABG sampling is a procedural skill pH, pO2, pCO2 and HCO3 plays the most crucial role in the ABG analysis Electrolytes and other blood elements can also be assessed in the ABG report

18. Summary

19. For diagnosing the primary ABG abnormality

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