Professional Documents
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Acid Base and Abg
Acid Base and Abg
Acid Base and Abg
https://www.medicinenet.com>main>art
https://www.webmd.com/lung/arterial-blood-gas-test
pH
(7.35 – 7.45)
ACIDIC ALKALOTIC
<7.35 >7.45
INDICATION
CONTRAINDICATION
COMPLICATION
PURPOSE
• Measurement of oxygen and carbon dioxide levels in blood (how
well the lungs can provide adequate oxygen to the body and
subsequently remove carbon dioxide). Kidney & lungs work to
maintain the acid base balance.
• Also measure pH level, which is normally balanced when healthy
• When inhale and exhale, your lungs move oxygen into your
blood and push carbon dioxide out. That process called gas
exchange.
https://www.medicinenet.com>main>srt
https://www.webmd.com/lung/kidney/arterial-blood-gas-test
INDICATION
• Respiratory Failure
• Cardiac Failure
• Liver Failure
• Renal Failure
• Multiorgan Failure
• Sepsis
• Toxin
• Ventilated patients
https://patient.info/doctor/arterial-blood-gases-indications-
and-interpretation
CONTRAINDICATION
• Severe coagulopathy
• Anticoagulation theraphy
• Absent ulnar circulation
• Arteriovenous fistula
• History of arterial spasms
Nottingham University Hospital/perfoming arterial blood gas
sampling page 5
COMPLICATION
• Hematoma
• Severe Bleeding
• Infection
• Thrombus
• Nerve Damage
https://www.ncbi.nlm.nih.gov/books
ABG INTERPRETATION
https://www.medicalnewstoday.com/articles/313110.php
SIGNS AND SYMPTOMS OF RESPIRATORY ACIDOSIS
• Levels of carbon dioxide and oxygen in the blood are not balanced
• When inhale introduce oxygen into the lungs. When exhale release carbon
dioxide (waste product)
• Breathe too fast or too deep low. This causes the pH of the blood to rise and
become too alkaline
https://www.healthline.com/health/respiratory-
alkalosis#treatment
SIGN AND SYMPTOM OF RESPIRATORY ALKALOSIS
Miscellaneous
Light Numbness
headedness dysrhythmias Dry mouth
and tingling
Tetanic
Inability to spasms of
confusion palpitations
concentrate the arm and
legs
Blurred
vision diaphoresis
Stupor or Warm,
lethargy
coma flushed skin
restlessness
Interpretation of the Arterial Blood Gas/self learning packet
page 8
METABOLIC ACIDOSIS CAUSES
• Renal failure
• Ketoacidosis
• Alcoholic
• Ingestion of toxin
Morgan & Mikhail’s Clinical Anesthesiology page 1151
METABOLIC ALKALOSIS
https://www.osmosis.org/lean/Metabolic_alkalosis
SIGN AND SYMPTOM METABOLIC ALKALOSIS
disorientation
https://www.medicalnewstoday.com/articles/313110.php
CASE SCENARIO
• History
A 25 years old man, with no significant medical history, present to
emergency department with a 2 day history of fever, productive cough and
worsening breathlessness
• Examination
He is hot and flushed with a temperature of 39.0 *C. he does not appear
distressed but is using accessory muscle of respiration. There is diminished
chest expansion on the left with dullness to percussion, bronchial breathing
and coarse crackles in the left lower zone posteriorly
QUESTIONS
1. a) describe her gas exchange
b) describe her acid base status
2. should the patient receive supplemental O2?
NORMAL VALUE
H+ 31.8 mmol/L 35 – 45
pH 7.50 7.35 – 7.45
PCO2 28.1 mmHg 35 – 45
PO2 57.8 mmHg >80
Bicarb 23.9 mmol/L 22 – 28
BE -0.5 mmol/L -2 to +2
S02 88.7 % >96 %
K 3.7 mmol/L 3.5 – 5
Na 138 mmol/L 135 – 145
Hb 15 g/dL 13 – 18
Glucose 5.4 mmol/L 3.5 – 5.5
ANSWER
• 1. a) type 1 respiratory failure
b) uncompensated respiratory alkalosis
• 2. yes
CASE SCENARIO
• History
A 35 years old woman with type 1 diabetis mellitus is brought to the
emergency department by ambulance after being found severely unwell in
her house. Following a discussion with her partner, she has not been eating
for the past few days due to a vomiting illness and as a precaution, has also
been omitting her insulin
• Examination
on examination, she appears drowsy and dry mucous membranes. Her
breath smells of acetone and her respirations are deep and sighing
PULSE RATE 88 beats/min
RESPIRATORY RATE 22 breaths/min
BLOOD PRESSURE 124/76 mmHg
SPO2 (ROOM AIR) 90 %
DXT 25 mmol/L
NORMAL VALUE
H+ 88.9 mmol/L 35 – 45
pH 7.05 7.35 – 7.45
ON 10L O2 BY MASK PCO2 11 mmHg 35 – 45
PO2 187 mmHg >80
Bicarb 6.0 mmol/L 22 – 28
BE -25.2 mmol/L -2 to +2
S02 99.8 % >96 %
K 4.6 mmol/L 3.5 – 5
Na 141 mmol/L 135 – 145
Hb 12 g/dL 11.5 – 16
Glucose 35 mmol/L 3.5 – 5.5
1. a) hyperventilation (secondary)
b) severe metabolic acidosis with partial compensation
2. Diabetic ketoacidosis
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