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Allens Test
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Prep site
Pierce skin over arterial at a 6090 angle
Obtain 3 mL of blood without
air bubbles
Twirl syringe to mix heparin
with sample
Place in ice
Hold pressure for 5-10 minutes
Wait 30 minutes before drawing
sample if O2 setting changed
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Documentation
Must Include:
Chart By Exception:
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When H+
CO2 + H2O H2CO3 HCO3- + H+
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Components of ABG
Interpretation of ABGs
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10
pH
0= pure acid
14= pure base
7.0 =neutral (equal parts acids/base)
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11
Acidosis
Decrease in pH resulting from an increase in
hydrogen ion concentration
H+
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12
Alkalosis
Increase in pH resulting from a decrease in
hydrogen ion concentration
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13
Absent
Partial
Complete
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14
CO
2
HCO3
Buffe
r
PO2
hgb
ph
Base
acid
15
Step 2
Is the pH on the acid or alkaline side?
Normal pH 7.35 - 7.45
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16
Step 3
Does the PaCO2 match the pH?
Normal PaCO2 35-45 mm Hg
PaCO2 > 45
PaCO2 < 35
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17
Step 3
Does the HCO3 match the pH?
HCO3 < 22
HCO3 > 26
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18
Lungs
(Respiratory)
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Kidneys
(Metabolic)
19
Step 4
What is the extent of compensation?
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20
Respiratory acidosis
Respiratory alkalosis
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21
Metabolic acidosis
Metabolic alkalosis
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22
Oxygen
Oxygen is carried in the blood in two ways:
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23
PaO2
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80-100 mm Hg
60-80 mmHg
40-60 mmHg
below 40 mmHg
24
25
ABG Example
pH 7.48
PaCO2 32
HCO3 22
Normal
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26
Acid-Base Disorders
ABG Disorder
Respiratory Acidosis
CNS
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depression
(barbiturate or sedative
OD)
Asphyxia
Hypoventilation
COPD
Respiratory muscle
weakness (GuillainBarre)
Chest wall
abnormality (obesity)
Diaphoresis
Headache
Tachycardia
Confusion
Restlessness
Apprehension
27
Acid-Base Disorders
ABG Disorder
Possible Causes
Signs and
Symptoms
Respiratory Alkalosis
Hyperventilation
Rapid,
Respiratory
stimulation (septicemia,
encephalitis, brain
injury, salisylate
poisoning)
Gram-negative
bacteremia
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deep
respirations
Paresthesias
Light-headedness
Twitching
Anxiety
Fear
28
Acid-Base Disorders
ABG Disorder
Possible Causes
Signs and
Symptoms
Metabolic Acidosis
HCO3-
Rapid,
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depletion
from diarrhea
Excessive production
of organic acids
Inadequate excretions
of acids from renal
disease
DKA, Lactic acidosis
Shock, GI fistulas
deep breathing
Fruity breath
Fatigue
Headache
Lethargy
Nausea
Vomiting
Coma
29
Acid-Base Disorders
ABG Disorder
Metabolic Alkalosis
Loss
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of hydorchloric
acid from vomiting or
NG suctioning
Loss of hydrogen
ions due to increased
renal excretion from
diuretic therapy
Excessive alkali
ingestion
Slow, shallow
respirations
Muscle twitching
Hypertonic muscles
Restlessness
Tetany (convulsion)
Coma
30
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31
pH 7.33
PaCO2 55
HCO3 29
PaO2 60
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32
4.
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33
pH 7.55
PaCO2 28
HCO3 24
PaO2 90
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34
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35
pH 7.32
PaCO2 34
HCO3 17
PaO2 95
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36
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37
pH 7.52
PaCO2 49
HCO3 40
PaO2 93
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38
2.
3.
4.
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39
pH 7.35
PaCO2 70
HCO3 30
PaO2 55
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40
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41
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42