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. NORMALABG 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. Blood draw points for ABG analysis

12. 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

14. 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.

15. 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)

16. 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)
•

17. 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

18. 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

19. Complications related to ABG sampling
• Arteriospasm
• Hematoma
• Nerve damage
• Fainting
• Other problems can include a drop in blood
pressure, complaints of feeling faint, sweating
or pallor that may precede a loss of
consciousness.

20. THANK YOU