S.

NO BEHAVIOURAL CONTENT TIME TEACHER’S LEARNER’S AV AIDS

OBJECTIVES ACTIVITY ACTIVITY

Definition
1 define ABG analysis 2 min Explaining Listening Real article
An arterial blood gas (ABG) test is a blood
test that requires a sample from an artery in
human body to measure the levels of oxygen
and carbon dioxide in the blood.

The test also checks the balance of acids and

bases, known as the pH balance, in the
blood.

describe the purpose of ABG
2 analysis
Purposes
2min Explaining Listening Real article
 To determine the ph of blood and the
partial pressures of carbondioxide
(PaCo2) and oxygen (PaO2) within it
 The test also indicates how well the lungs
and kidneys are interacting to maintain
normal blood Ph (acid-base balance)
 To check for severe breathing and lung
problems such as asthma, cystic
fibrosis, chronic obstructive pulmonary
disease (COPD), or obstructive sleep
apnea
 To check how treatments for
your lung problems are working
 To check whether you need extra oxygen
or other help with breathing
 To check your acid-base balance. You can
have too much acid in your body
from kidney failure, a severe infection,
specific toxic ingestions, or complications
of diabetes (DKA).
 enlist the indications for 3 min Explaining Listening Real article
3 specimen collection for Indications
ABG analysis
 Respiratory failure - in acute and chronic
states.
 Any severe illness which may lead to a
metabolic acidosis - for example:
o Cardiac failure.
o Liver failure.
o Renal failure.
o Hyperglycaemic states associated
with diabetes mellitus.
o Multiorgan failure.
o Sepsis.
o Burns.
o Poisons/toxins.

 Ventilated patients

 Severely unwell patients from any cause

list down the advantages and - affects prognosis.
4 disadvantages of ABG
Advantages 2min Explaining Listening Real article
analysis
 Direct measurement of PaO2 and
PaCO2 of critically ill patients
 Also gives values for acid base status
and electrolytes

Disadvantages
 Non arterial samples
 either inadequate or excessive
anticoagulant in the sample
 Requires invasive procedures
 It is more difficult to obtain than
venous or capillary blood sample
 It is more painful for the patient and
it can be potentially dangerous, if the
 correct procedure is not followed
5 enumerate about the 6min Explaining Listening Real article
equipment needed for
specimen collection and sites Equipment needed
for ABG analysis
1. One 1cc to 5 cc vented, pre-
heparinized, syringe
2. One biohazard labelled plastic bag
3. Alcohol pre pad
4. Iodine pad
5. One adhesive bandage
6. Lab form
7. Ice
6 explain the procedure of
sample collection for ABG Preliminary assessment 15min Explaining Listening Demonstration
analysis  Level of consciousness and
understanding of the patient
 Vital signs
 Allergy to tape or cleaning solutions
 Doctor’s order

Preparation of the patient and ward

 Ensure that sweeping and mopping of

ward is completed
 Explain procedure to the patient
 All articles should be assemble at patient
bed side
 Proper lighting of the ward
 Provide privacy by using screens
 Check the agency protocol about using
cleaning solutions
 Fix disposable plastic bags in holders on
the trolley. Place within reach for
disposal of contaminated equipments

Sites of ABG sampling

 Radial artery
 Femoral artery
  Brachial artery

Procedure of specimen collection for ABG

analysis

 Explain the procedure to the patient - it is

painful
 Check for sensitivities to latex and other
substance
 Verify collection requirements
 Perform handwashing and done gloves
 Assess collateral circulation
 If the radial artery is to be used, perform
Allen's test to confirm collateral blood
flow to the hand

 Allen’s test

 Elevate the hand and make a fist for

approximately 30 seconds

 Apply pressure over the ulnar and the

radial arteries occluding both (keep
the hand elevated).

 Open the hand which will be

blanched

 Release pressure on the ulnar artery

and look for perfusion of the hand
(this takes under eight seconds)

 If there is any delay then it may not

be safe to perform radial artery
puncture

 Position arm and ask patient to extend

wrist - a pillow under the hand may
 improve comfort.
 Locate radial artery and clean site
 Administer local anesthetic and it is
optional
 ABG syringes usually come prepacked
and are heparinized. Some contain a
vacuum and thus the plunger does not
always need to be pulled. (Check with
your department as to which they use).
 Prepare equipment and clean gloved
nondominant finger
 Pick up equipment and uncap and
inspect needle
 Relocate radial artery and hold fingers
firmly over the pulsation
 Insert needle at a 30 to 45 degree angle,
slowly direct it toward pulse, and stop
when a flash of blood appears
 Allow syringe to fill to proper level
 Once you have taken your sample and
withdrawn the needle, apply firm
pressure for a minimum of two minutes
(longer if the patient is on any
antiplatelet medication or anticoagulants

After care of patient and articles

 Make the patient comfortable

 Expel air bubbles, cap syringe, mix, and
label specimen
 Replace equipment’s
 Discard the disposable items
 Wash hands
 Document the procedure
 Transfer the specimen to lab as soon as
possible