Quality Assurance in Arterial Blood Gases
•Download as PPTX, PDF•
1 like•1,844 views
This document discusses quality assurance in arterial blood gas analysis. It defines quality assurance as a total process to guarantee the quality of laboratory reports. A quality assurance program ensures that personnel follow quality practices, instruments are working properly, and high-quality reports are generated with proper documentation. The document outlines pre-analytical, analytical, and post-analytical factors that can impact quality, such as patient identification, sampling issues like air bubbles, storage conditions, and equipment or reporting errors. It stresses the importance of quality assurance to prevent misdiagnosis, missed diagnosis, and delayed diagnosis.
More Related Content
What's hot
What's hot (20)
Similar to Quality Assurance in Arterial Blood Gases
Similar to Quality Assurance in Arterial Blood Gases (20)
More from Dr.Rittu Chandel MBBS, MD
More from Dr.Rittu Chandel MBBS, MD (18)
Recently uploaded
Recently uploaded (20)
Quality Assurance in Arterial Blood Gases
- 1. QUALITY ASSURANCE IN BLOOD GAS ANALYSIS Dr.Rittu Chandel Junior Clinical Biochemist Breach Candy Hospital Trust, Mumbai www.drrittuchandel.com
- 2. OVERVIEW • Quality • Quality Assurance • Quality Assurance in Arterial Blood Gases
- 4. QUALITY Quality is a mutual responsibility
- 5. WHY QUALITY IS NEEDED
- 7. QUALITY ASSURANCE The WHO definition of quality assurance is a total process whereby the quality of lab reports can be guaranteed Laboratory's quality assurance program will provide the following (1) Quality practices are followed by all personnel involved in the laboratory (2) The technologist performing the test will know when instruments are working properly (3) High-quality report generated (4) Documentation
- 8. QUALITY ASSURANCE CYCLE • Right result, at the • Right time, on the • Right specimen, from • Right patient
- 9. CLIA Standards for Quality Assurance • Pre Analytical • Analytical • Post Analytical • Communication • Documentation
- 11. QUALITY ASSURANCE • Systematic process used to monitor, document, and regulate the accuracy and reliability of the Lab report • Errors in blood gases may occur before, during, or after actual analysis of the sample
- 12. QUESTION • Lab receives arterial blood sample from emergency department. Blood gas testing is requested. Sample was transported by pneumatic tube within 10 minutes from sampling. You notice an air bubble in the syringe. • What would you do? • a) Sample is acceptable. I would expel the bubble and perform the analysis. • b) Sample is not perfect, I would expel the bubble and perform the analysis. I would report the result with a comment. • c) Sample is not acceptable. I would reject the sample and request repeated sampling. • d) I would call a physician and ask him to decide what to do
- 14. PATIENT IDENTIFICATION • Proper labeling is must • Unique patient identifier bearing name, date and collection time • patient's body temperature • Pediatric age group
- 15. SAMPLING • Painful sampling may result in pain, anxiety and induced hyperventilation which can result in reduced pCO2 • During sampling from arterial catheter there is risk of dilution with flush solution • There are chances of puncturing a vein and mixed blood can be obtained • If liquid heparin (sodium or lithium, 1,000 units/mL of blood)
- 16. AIR BUBBLES • Room air has a pO2, of approximately 150 mm Hg (sea level) and a pCO2 of essentially zero • Thus, air bubbles that mix and equilibrate with arterial blood will shift the paO2 toward 150 mm Hg and will lower the paCO2 • without air bubbles with air bubbles • pO2 70 mm Hg pO2 90 mmHg • pCO2 45.6 mmHg pCO2 45.4 mmHg
- 17. CLOTTING • Blood sample should be slowly mixed between the palms to avoid clotting • Clotting can block the sample pathway of the blood gas analyzer • This can give error, need resampling and delay the future samples
- 18. PROLONGED STORAGE • Cellular metabolism continues after the blood is collected and thus the requirement of the cold chain • Leukocytes and platelets continue to consume oxygen Drop in pH, glucose , pO2 • Rise in the values of lactate, ionized calcium and pCO2
- 19. QUESTION • 8:00 a.m. • lab receives arterial blood sample, for blood gas testing for an ICU patient. Sample has been delivered to the lab in a plastic syringe, on ice.Sampling time was 6:30 a.m. • What would you do? • a) Sample is acceptable. I would thouroughly mix the sample and perform the analysis. • b) Sample is not perfect, but I would accept it for analysis after thouroughly mixing it. I would report the result with a comment . • c) Sample is not acceptable. I would reject the sample and request repeated sampling. • d) I would call a physician and ask him to decide what to do.
- 20. ANALYTICAL • Equipment related • Ask for HELP • Preventive maintenance
- 21. POST ANALYTICAL • Faults may occur in reporting • Interpretation of test results
- 22. TAKE HOME MESSAGE Quality assurance is important It will prevent • Misdiagnosis • Missed diagnosis • Delayed diagnosis
- 23. THANK YOU • www.linkedin.com/in/rittuchandel • me@drrittuchandel.com • www.drrittuchandel.com
Editor's Notes
- Mutual responsibility,, Provision of precise and accurate laboratory results optimize medical management. Inappropriate test selection, unnecessary investigations and incorrect test results not only have serious health implications but are also a financial burden to the individual and community.
- it involves determining a quality goal, deciding whether or not the goal has been achieved, and implementing corrective action if the goal has not been reached.