ABG-It is an vital &fastest test to assess the patient haemodynamics , this ppt explains you briefly about ABG meaning, components,sampling, allens test & nurses roles....

1. ARTEREAL BLOOD
GAS
MEANING,BRIEF
GUIDE FOR
NURSES
MURUGESH H J RN
ICU 02 (AL HAYATH)
KFCH HOSPITAL JIZAN

2. ARTERIAL BLOD GAS….
• Arterial blood gas (ABG):
• Arterial blood gas (ABG) sampling by direct vascular puncture is a procedure often
practiced in the hospital setting. ABG is an rapid analysis make it an important tool
used by physicians to direct and redirect the treatment of their patients, especially in
patients who are critically ill, to determine gas exchange levels in the blood related to
respiratory, metabolic, and renal function….
• The sampling of the blood levels of oxygen and carbon dioxide within the arteries, as
opposed to the levels of oxygen and carbon dioxide in venous blood. Typically the acidity,
or pH, of the blood is measured simultaneously with the gas levels in ABG sampling.
• ABG –its an simple investigation to rule out acidosis OR alkalosis,QUICK Guide tool to
assess haemodynamics…

3. ABG SAMPLING ..
• COMMON SITES FOR ABG SAMPLING …
• RADIAL ARTERY , BRACHIAL ,RARELY;FEMORAL& PEDAL ARTERY SITE ….
• ABSOLIUTE CONTRA- INDICATIONS TO AVOID TO DO ABG
• LOW PLATELET COUNT (<20K) , COAGULAOPATHY ( HIGH INR ) ,ON HEPARIN IV
INFUSION etc…..
• Local infection.
• Distorted anatomy.
• Presence of arterio-venous fistulas.
• Peripheral vascular disease of the limb to be sampled.
• Severe coagulopathy or recent thrombolysis.

4. INDICATIONS TO DO ABG ….
• Respiratory failure - in acute and chronic states.
• Any severe illness which may lead to a metabolic acidosis - for example:
Cardiac failure. Liver failure. Renal failure. ...
• Ventilated patients.
• Sleep studies.
• Severely unwell patients from any cause …..

5. ALLENS TEST….
• ALLENS TEST ….
• ITS AN SIMPLE TEST TO SELECT & EXAMINE THE RADIAL ARTERY FLOW FOR ABG
SAMPLING
• The Allen test is a first-line standard test used to assess the arterial blood supply of the hand. This test is
performed whenever intravascular access to the radial artery is planned or for selecting patients for radial
artery harvesting
• A positive Allen test means that the patient does not have an adequate dual blood supply to the hand,
which would be a negative indication for catheterization, removal of the radial artery, or any procedure which
may result in occlusion of the vessel.SO NOT SELECT ARTERY FOR SAMPLING…
• Negeitive Allen test means that the patient have an adequate dual blood supply to the Hand SO WE
CAN CHOOSE THE ARTERY FOR SAMPLING …….

6. COMPONENTS OF ABG
COMPONENTS
pH
DESCRIPTION
Hydrogen
ABG VBG
7.35 - 7.45 7.31-7.41
PaCO2 Carbon dioxide 35 - 45 mmHg 41-51mmhg
HCO3
- Bicarbonate 22 – 26mmol 22-26mm
...
Normal ABG Levels.
PAO2 Partial pressure of oxygen 75 - 100 mmHg.. 35-45mmhg
SO2 Oxygen saturation 94 - 100% 68-77%
BE Base excess -2 to +2 mEq/l -2to +2mEq/l

7. How to identify…..
• Look at pH – if pH< 7.40 - its Acidosis; > 7.40 - Alkalosis.
• Suppose If pH indicates acidosis, then look at paCO2 and HCO3
-
• If paCO2is ↑, then it is primary respiratory acidosis
• Example: if pHis 7.25& paco2 is 58 means RESPIRATORY ACIDOSIS ...
• If paCO2↓ and HCO3
- is also ↓→ primary metabolic acidosis. ...
• Example : if pH is 7.25 & paco2 is 28 & HCO3 is 14.8 then result is METABOLIC ACIDOSIS
• If pH is↓& HCO3
- ↓ , then it is acidosis
• If pH ↑ & HCO3
- ↑, then it is alkalosis METABOLIC ALKALOSIS
• IF pH ↑ & paCO2is ↑,then it is RESPIRATORY ALKALOSIS

8. COMMON SITES

9. NURSES ROLE…
• **** MONOTRING THE SITE FOR GOOD PALPABLE PULSE, ARTERY
CONVEINEIINCE , HISTORY OF THROMOBOSIS OR HEMATOMA..TO
DO ALLENS TEST….
• ***DON’T PRICK PATIENT IF PATIENT HAS HISTORY OF BLEEDING
DISORDERS, COAGULAPATHY, LOWPLATELETCOUNT, ONGOING
HEPARIN OR POSTTHROMBECTOMY INITIAL HOURS
• **** WATCH SITE FOR BLEEDING, OOZING, DICOULRISATION,
PARALYSIS( 5 Ps)
• ***AVOID SAMPLING ERRORS- FLUSH THE SYRING WITH HEPARIN,
WHILE AVOID AIR ENTRY,CALIBERATETHEABG MACHINE DIALY..

10. CONT…..NURSESROLE
• ***RECORD THE CURRENT ONGOING O2 FLOW&VENTILTOR
PARAMETERSINGS
• ***INFORM DOCTOR IMEEDIATELY IF
NOTICED DISCOURATION& NO PULSE IN SAMPLE SITE…

11. •THANK YOU ALL