NURSING IMPLICATIONS IN ABG ANALYSIS

What is ABG (Arterial Blood Gas Analysis?

It is the measurement of oxygen, carbon dioxide & pH level in blood which is normal when healthy.
 

    

Indications:

· Ventilator patient

· Regulate electrolyte therapy

· Establish preoperative baseline parameters

Nursing Role During the Procedure: 

• Obtain consent

• · Usually radial artery of non dominant hand of patient is preferred to collect the sample.
• · Palpate the pulse over lateral anterior aspect of wrist with index finger by placing the wrist extended at 20-30 degree.
• · By informing patient insert the needle at 45 degree over the point of maximal radial artery pulsation.
• · Heparin should be added or Pre -heparinized vacutainer can be used.
• · Remove the needle after collecting sample , apply pressure for 3-5 mins & apply safeguard after that.
• · The sample should be analysed within 10 minutes as delays can affect the accuracy of results. 

ABG Interpretation:

PaCO2 (ventilation)  - Partial Carbon Dioxide

PaO2 (oxygenation)  - Partial Oxygenation

HCO3 (metabolism)  - Bicarbonate

O2 Sat                     - Oxygen saturation

pH                           - Acid/ Base balance

BE                           - Base excess

Normal Values :

pH                      - 7.35-7.45

PaCO2                - 35-45 mm hg

HCO3                 - 22-26 mEq/L

O2 saturation     - 96-100%

PaO2                  - 85-100 mm hg

BE                      - -2 to +2 mmol/L

pH	PaCO2	HCO3	Acid base imbalance
Decrease	Increase	Normal	Respiratory acidosis
Increase	Decrease	Normal	Respiratory alkalosis
Decrease	Normal	Decrease	Metabolic acidosis
Increase	Normal	Increase	Metabolic alkalosis
Decrease	Increase	Increase	Respiratory acidosis with metabolic compensation
Increase	Increase	Increase	Respiratory alkalosis with metabolic compensation
Decrease	Increase	Decrease	Metabolic & respiratory acidosis
Increase	Decrease	Increase	Metabolic & respiratory alkalosis

Why ABG is used ?

• ·         To assess proper oxygenation of lungs
• ·         To assess proper exhalation of carbon dioxide from lungs
• ·         To assess the renal function

Complications related to ABG sample collection Process :

• ·        Arteriospasm
• ·      Hematoma
• ·      Nerve damage
• ·      Fainting
•        Others : hypotension, loss of consciousness, swelling & pallor