By Iain Hennessey, Alan Japp
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Additional resources for Arterial Blood Gases Made Easy
In in poncreohhsl Guiding II ealli"'" and ~itonng respon5e - Mechanically ventiloted JXItients Potients receiVing non-Invosive o"i,ted vcntilolton Patients w,1t. "",1dIId lo, '''0(1. , mol'" 1raun'Ia. ocute obdomcn, poisCO'Iing, ~oocl;ocJrenol/hepo1i<: k>iIur.. JootJe• •eaoocidosi. 9 COMMON ABG VALUES The followin/o; parameters arc commonly found on ABC reports and ar", proviJ~ for wC",rence (normal ranges in btadcts): W 135-45 nmol/ll < 35 _ olkoloemio, > 45 = ocidoemio Concentration of free hydrogen ions: lhis is a measure of how addle or i1lkalinc a ~lution IS.
The sampling site with an alcohol wipe. • Ste,ldy your hand on tile patient's hand, as showlI, the n~le at 45°, bevel facing up. • th~n insert Be surf> 10 insprt the need Ie slowly to minimise the risk of arterial spasm. wle is in the artery a flash of pulsatile blood will appear in the barrel of the needle. Most ABC syringes will th('tl fill under arterial pr"'SSllr(> (see info box over page). • Obtain at least 3 UlL of blood before withdrawing. l' ,atE' col1aleral cin:ulalion. (Slogoff S, Kc-"ts AS, Arlund C.
Metabolic aridOf;is is recognised on an AI}(; by low HCo, (and negative bas<' exC('5S (BE». :0:!. If resprratory com~bonIS overwhelmed, an acidaf'mia will result. ~ty must be judged aN'ording to both thto lmderlying process and the resulhng acidat'mia An J ICO;, < 15 mmol/L (or BE < 10) indiCi1t~ a severe acidotic process whereas ... idaenua. piratory compcnsatiun. 15; I'· > 70) may lead to arculal0'1' shod:, ~ dysfuncLion, and, uILimatcly death. >1S are chscussed in greater detail ill the relevant Casel in Part 2.