ARTERIAL BLOOD GAS

What is an Arterial Blood Gas

(ABG)?
• An ABG is a blood test that measures the acidity,
or pH, and the levels of oxygen (O2) and carbon
dioxide (CO2) from an artery.

• Used to check the function of the patient’s lungs

and how well they are able to move oxygen into
the blood and remove carbon dioxide.

• This test is commonly performed in the ICU and ER

setting
ABG PUNCTURE SITES
 MODIFIED ALLEN'S TEST

• The Allen test is a first-line

standard test used to assess the
arterial blood supply of the hand.

• This test is performed whenever

intravascular access to the radial
artery is planned or for selecting
patients for radial artery
harvesting, such as for coronary
artery bypass grafting or for
forearm flap elevation.
Procedure for Radial Check the medical record to (1)

Artery Puncture 1
confirm the order and indications
and (2) determine the patients
primary diagnosis,
history
Confirm steady-state conditions (20 to 30
2 minutes afterchanges).

Obtain and assemble necessary equipment

3 and supplies.

Wash hands and don barrier protection (e.g.,

4 gloves, eyewear).

Identify the patient using current patient

5 safety standards.
Procedure for Radial Explain the procedure to the

Artery Puncture 6
patient.

Position the patient, extending the

7 patient’s wrist to approximately 30
degrees.

Perform a modified Allen test, and confirm

8 collateral circulation.

Clean site thoroughly with 70% isopropyl

9 alcohol or an equivalent antiseptic.

Inject a local anesthetic subcutaneously

10 /periarterially, wait 2 minutes for effect (optional).
Procedure for Radial Use a preheparinized blood gas kit

Artery Puncture 11
syringe, or heparinize a
syringe and expel the excess (fill
dead space only).

Palpate and secure the artery with one

12 hand.

Insert the needle, bevel up, through the

13 skin at a 45-degree
angle until blood pulsates into the syringe.

Allow 1 ml of blood to fill syringe (the need

14 to aspirate
indicates a venous puncture).

Apply firm pressure to puncture site with sterile

15 gauze until the bleeding stops.
Procedure for Radial Expel any air bubbles from the

Artery Puncture 16
sample, and cap or plug the
syringe.

Mix the sample by rolling and inverting

17 the syringe.

Place the sample in a transport container

and chilled or not, depending on analyzer
18 manufacturer recommendation.

Dispose of waste materials and sharps

19 properly

• Document the procedure and patient status in

20 the medical record and on the specimen label.

• Check the site for hematoma and adequacy of
distal circulation.
Recommended Equipment for Percutaneous
Arterial
Blood Sampling
• Standard precautions barrier protection (gloves, safety
goggles)
• Preheparinized blood gas kit syringe (1 to 3 ml)
• Short-bevel 20- to 22-gauge needle with a clear hub (23- to
• 25-gauge for children and infants)
• Patient and sample label
• Isopropyl alcohol (70%), povidone-iodine (Betadine) (check
patient for iodine sensitivity), or chlorhexidine swabs
Recommended Equipment for Percutaneous
Arterial Blood Sampling

• Sterile gauze squares, tape, bandages

• Puncture-resistant container
• Ice Slush
• Towels
• Sharps container
• Local anesthetic (optional)
• Hypodermic needle (25- or 26-gauge)
• Needle capping device
Components of Arterial Blood Gas
STEPS IN ANALYZING ACID BASE
BALANCE

1. Categorize pH
2. Determine Respiratory Involvement
3. Determin Metabolic Involvement
4. Assess for Compensation
ABG NORMAL RANGE

pH= 7.35- 7.45

PaCo2= 35-35 mmHg
HCo3- = 22-26 mEq/L
ABG INTERPRETATION
CHARACTERISTICS OF ACID-BASE
DISTURBANCES
 TIC-TAC-TOE METHOD

• It is FULLY COMPENSATED if pH is normal.

• It is PARTIALLY COMPENSATED if all three (3) values are

abnormal.

• It is UNCOMPENSATED if PaCO2 or HCO3 is normal and the other

is abnormal.
THANK YOU !