Paco 2 measures the partial pressure of carbon dioxide co 2 dissolved in arterial blood pao 2 measures the partial pressure of oxygen dissolved in arterial blood hco 3measures the concentration of bicarbonate ions sao 2 measures the percentage of hemoglobin saturated with. Recall that each change in pco2 of 10 mm hg results in a ph change of 0. Blood gases are helpful to assess the effectiveness of ventilation, circulation and perfusion. The medical plan of care for the neonatal patient includes the frequency of blood gas determination, and it is every care providers responsibility to be cognizant of each blood gas sample drawn on the patient.
Identify the relationship between oxygen saturation and pao2 as it relates to the oxyhemoglobin dissociation curve. That makes the interpretation of these abg results is uncompensated respiratory acidosis. Arterial blood gas analysis is an essential part of diagnosing and managing a patients oxygenation status and acidbase balance. The cause of the acidosis is the p a co 2, which is the respiratory component of the abg results. However, the more complicated and in some ways more important part of abg analysis is ph regulation. When one thinks of abg analysis, oxygenation may come to mind first. Knowing the different normal lab values is an important step in making an informed clinical decision as a nurse. Abg interpretation ppt if this is your first visit, be sure to check out the faq by clicking the link above.
See arterial blood gases, section on arterial sampling and measures of oxygenation and mechanisms of hypoxemia and pulse oximetry and simple and mixed acidbase disorders. Blood gas analysis is a routine procedure performed on newborn babies receiving respiratory support in the neonatal intensive care. There are limited randomised trial data which establish that any one ventilation. There is little question that when any patient, including a neonate, is critically ill, the abg results give clinicians essential information, i. The ph indicates a severe acidosis, and a pco2 of 72 is definite hypercarbia. Graph paper timings etc the graph paper that the ecg records on is standardized to run at 25mmsecond, and is marked.
Get a printable copy pdf file of the complete article 479k, or click on a page image below to browse page by page. Blood gas analysis debbie fraser, mn, rncnic b lood gas analysis is one of the major tools in assessing the respiratory status of the newborn. This guideline is not intended to be adhered to rigidly, but merely to provide some rationale behind interpretation of blood gases and possible changes to ventilation settings in response. Values for the term and preterm infant differ slightly from. Newborn hypoglycaemia refer to online version, destroy printed copies after use page 2 of 21 document title. She is active in the national association of neonatal nurses and. Explain the types of errors that can occur with blood gas analysis. Full text full text is available as a scanned copy of the original print version. Abou mehrem, md assistant consultant king abdulaziz hospital. The usefulness of this diagnostic tool is dependent. Guidelines for the interpretation of the neonatal electrocardiogram a task force of the european society of cardblogy p. Determine the cause of the acidosis or alkalosis by looking at the pco2 and hco3if ph file of the ebook or other reading material from a web site such as barnes and noble to be read from the users computer or reading device.
Rate number of ps atrial rs ventricular per minute 6 second 30 squares x 10 minute rate. Aug 6, 20 this pin was discovered by mary stover vaughn. The chart visually demonstrates how well a baby tolerated the birthing process by providing five categories the rows in the chart by which one must rate the newborn on a scale of 0 to 2 the columns of the chart, where 0 is the lowest undesirable and 2 is the highest desirable. Diagnostic and laboratory tests are tools that provide invaluable insights and information about the patient. Blood gas interpretation for neonates better safer care. The value of timely and accurate interpretation of blood gas results cannot be questioned. She is an awardwinning author and founder of the internationally recognized s. His paco2 is lower than normal, reflecting the lungs attempt to compensate. Blood gas interpretation in the neonate what do you need to know. Neonatal nurse practitioner the ronald mcdonald childrens hospital at loyola university medical center objectives at.
Arterial blood gases abg results reflect underlying pathology and interpretation of the results are often compounded by ongoing disease processes and clinical interventions. Illustrated apgar appearance, pulse, grimace, activity, respiration test scoring chart. These abg values reveal metabolic acidosis with partial compensation. Because the ph is abnormal, you know compensation is not complete. The classification and interpretation of blood gases are based on a set of normal values. Identify normal arterial blood gas values and interpret the meaning of abnormal values. Boniface general hospital, winnipeg, manitoba, canada.
Lab tests are used to help confirm a diagnosis, monitor an illness, and the patients response to treatment. Before making an interpretation of an abg it is always ofwise to check for the consistency of the report bicarbonateby the modified henderson equation. Each case is then followed by an explanation of the acidbase status, the oxygenation status and a summary of the patients clinical picture. So, a rise of 30 mmhg in pco2 should lower the ph by 0. This video tutorial is on how to setup arterial blood gas problems using the tic tac toe method. Respiratory compromise, which leads to hypoxia or diminished ventilation. Interpretation of the arterial blood gas selflearning packet. Blood gas interpretation in the neonate what do you need. Abgs made easy for nurses w tic tac toe method for. What i found was a somewhat mixed bag, in terms of current opinions regarding whether routine abgs are appropriate in healthy neonates. Interpreting and using the arterial blood gas analysis. Procedure neonatal pediatric arterial puncture policy 7. To adequately use this information, one must have a basic understanding of gas transportation and acidbase physiology. Easy blood gas quiz with answers, by lawrence martin, md.
Interpretation of arterial blood gases is an essence of critical care. Ventilation practices vary between and within nicus and neonatologists. Neonatal resuscitation refer to online version, destroy printed copies after use page 7 of 38 1 introduction spontaneous respirations are initiated in approximately 85% of babies born at term with an additional 10% responding to drying and stimulation. Blood gas analysis is one of the major tools in assessing the. As well, in a normal abg, the hco 3 and p co 2 a move in the same direction.
Abg values based on neonatal age prebirth 5 min 17 days scalp after birth after birth. As well, in a normal abg, the hco 3 and pco 2 a move in the same direction. Blood gas analysis is one of the most important diagnostic tools in the neonatal intensive care unit nicu. Abg values vary with age of neonate and even with gestational age table iii, iv. Interpret the results of various arterial blood gas samples. Used to determine along with ph and co2 source of acid base imbalance.
Approximately 3% will require positive pressure ventilation. Kristine antonelli karlsen is a neonatal nurse practitioner who has been involved in neonatal care in a variety of settings including transport, education, and patient care for 30 years. Juretschke, phd, rncnpt, apnnnpbc, ccns founderpresident, nicu solutions, inc. Both blood gas quizzes are based on information presented in my pulmonary physiology web sites, especially the four most important equations in clinical practice. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Steps to abg interpretation fully compensated acidbase disorders v v normal, but 7. In cases where blood gas values do not fall into any of the above classifications, an answer unable to determine will appear when using the interpreter.
756 1345 858 387 541 193 183 746 92 346 426 788 318 1483 1215 587 1437 343 602 434 1541 381 1272 649 965 1171 702 627 1041 667 627