Arterial Blood Gas
Indications: An ABG is ordered as a way to assess or manage a
patient’s respiratory and metabolic acid/base balance. The test
assesses the pH of a patient’s blood and is used as an indicator for
the particular cause of the acidosis or alkalosis.
An ABG is also used to measure adequacy of treatment for an acid/base
balance.
An ABG can also be used in the measurement of adequacy of oxygenation.
Type of Test and testing procedure:
An ABG is usually acquired through withdrawal of arterial blood.
Babies can be tested using whole blood through capillary heel sticks.
An ABG is usually collected from the radial artery. Before an ABG can
be preformed, a circulation test must be preformed to protect the
hand’s collateral blood flow. This is called the Allen Test.
Allen Test- Apply pressure to the radial and ulnar arteries,
eliminating blood flow to the chosen hand. Slowly release the
pressure on the ulnar artery. If the hand flushes, returning blood to
the hand by the ulnar artery, the test may be preformed. If the hand
does not flush, it indicates that there is poor collateral circulation
and this hand may not be used. Attempt to use the other wrist, if
unable to use either, the femoral artery or brachial may also be used.
The test may be preformed following a positive Allen test. An ABG
syringe contains approximately 0.2ml of heparin to prevent coagulation
of sample. Insert syringe at a 45-75 degree angle. Do not pull back
on syringe; allow the arterial blood pressure to fill the syringe.
After withdrawing 3ml, remove syringe and apply pressure. Because the
vessel is an artery, pressure mu...
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...it unless they are symptomatic.
Carboxyhemoglobin
One consideration that must be made when drawing an ABG is
carboxyhemogloblin. Carboxyhemoglobin is the binding of carbon
monoxide (CO) with the hemoglobin molecules in the blood. This occurs
with carbon monoxide poisoning, fire, and long-term heavy smokers.
The hemoglobin molecules bond much easier to CO than O2, thus causing
the carboxyhemoglobin level to rise quickly.
An increased carboxyhemoglobin level can cause a decreased pH, but a
low PaCO2. Thus, if a practitioner suspects CO poisoning or fire a
carboxyhemoglobin level must be drawn.
Normal Level: 5%
Interpreting Results:>5% and symptomatic, such as confusion, dyspnea
and severe headache
Treatment: High flow O2 and removal of causative agent. O2 will
counteract the CO level quickly.
While the respiratory and cardiovascular systems are most reliant on one another, all body systems require a functioning circulatory cycle in order to thrive. Blood circulation and consistent transfer of oxygen to cells is required to maintain cell and tissue life. Disturbances to this process will cause cells and tissues to die (Red Cross 48). This state of balance and functioning body systems is referred to as homeostasis, defined as a “condition of equilibrium in the body’s internal environment due to constant interaction of body’s many regulatory processes” (Tortura 8). Changes or disruptions to homeostasis are regulated by the Endocrine and Nervous systems of the body. The endocrine system is made up of glands placed throughout the body
If the barometric pressure is 760 using the ABG data what is the patient’s PAO2?
Anomalous systemic arterial supply to the lungs has been extensively described in association with other congenital abnormalities such as bronchopulmonary sequestration and hypogenetic lung syndrome (scimitar syndrome). In 1946, Pryce introduced the term ‘sequestration’ to describe congenital abnormalities characterised by an anomalous systemic arterial supply to the lung and atresia or hypoplasia of the pulmonary artery. Sequestration was defined by Pryce as a “disconnected (dislocated, ectopic) bronchopulmonary mass or cyst with an anomalous systemic blood supply”.
Then after threading a catheter through the needle, the anesthesiologist will withdraw the needle and leave the catheter i...
Techniques." Journal of Postgraduate Medicine 56.2 (2010): 98-102. Academic Search Premier. Web. 19 Nov. 2013.
Room 28, a 73-year-old married male and retired railroad engineer, presented to his local hospital with a chief complaint of dyspnea resulting in the inability to perform physical activity without difficulty in breathing or SOB. After observing Room 28’s SpO2 level of 83%, which demonstrated his hypoxemic state, he was sent to his local hospital for further testing in order to reveal any lung disease or abnormalities. Room 28 was diagnosed with severe emphysema demonstrated by a chest x-ray examination and an ABG analysis after resting 20 minutes on room air. Room 28 was prescribed continuous O2 therapy, by route of nasal cannula, at a 2L flow rate. Severe emphysema will be discussed along with pathogenesis, risk factors, diagnostic tools and
...f the clamps on the tubing to allow the IV solution to run freely. Slowly, decrease the flow of the solution to the appropriate rate as ordered by the physician. Using a small gauze pad, wipe away any excess blood or fluid on the surface of the skin. Then, using the pre-torn pieces of tape, secure the catheter hub and the IV tubing to the patient’s skin. Take extra caution not to kink the tubing. Once everything is secured, recheck the IV solution’s flow and then attend to the rest of your patients needs.
Peripheral artery disease is usually caused by atherosclerosis, which is when fatty deposits accumulate in the arteries of, most likely, limbs. This does affect all arteries throughout the body, then in turn, slowing the blood flow. PAD may also be due to inflammation of the blood vessels, injury to the extremities, or even exposure to radiation. “Peripheral arterial disease (PAD) affects approximately 10% of the American population” (Gurbir Dhaliwal; Peripheral arterial disease: Epidemiology, natural history, diagnosis and treatment; 2007). If not taken care of, PAD may lead to critical limb ischemia, open sores on the feet or legs that become infected by gangrene. The gangrene is then removed surgically, but doctors might have to amputate the extremity all together. Another issue that arises with PAD if it is not under control is the risk of stroke or heart attack. These can cause death to part of the heart or brain, or even death itself. The population more at risk would be smokers, diabetics, people who are obese, those with hypertension or hyperlipidemia, over the age of 50, have a family history of PAD, or those with a high level of homocysteine. If someone does fall into a few of these categories a physician can do a few tests to check for PAD. The doctor will more than likely start off with a physical exam, blood test, and possibly an ultrasound. From there the physician may try an ankle-brachial index, or ABI, which compares the blood pressure of the feet to the blood pressure of the arm. “An American survey of 2174 patients older than 40 years of age used the ankle-brachial index (ABI) as a screening tool, and showed a PAD prevalence of 0.9% between the ages of 40 and 49 years, 2.5% between the ages of 50 and 59 years, ...
In this discussion post we are to describe the structures and functions of the respiratory system. We were asked to include major organs and how they work within the body and to notate symptoms of failure within the respiratory system.
Chernecky, C. C., and B. J. Berger. Laboratory tests and diagnostic procedures. 5. St. Louis MO: W B Saunders Co, 2008. eBook.
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