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. Abg interpretation regulation of acid base balance normal serum ph is 7. Intensive care unit registered nurse resume samples. Mechanical ventilation a short course on the theory and application of mechanical ventilators robert l. Use of umbilical cord blood gas analysis in the assessment ncbi. Vents and abg interpretation 23 asthma 24 bronchiolitis score 26 cf 27 hemeonc 28 transfusion tips 29 ekg 31 fen 32 clinic and immunizations 3335 development chart 36 duty hour logging 3739 chain of command, when to call. Because the ph is abnormal, you know compensation is not complete. For example abgs with an alkalemic ph may exhibit respiratory acidosis and metabolic alkalosis. Determine the cause of the acidosis or alkalosis by looking at the pco2 and hco3if ph. However, the more complicated and in some ways more important part of abg analysis is ph regulation. Arterial blood gas analysis is a common investigation in emergency departments and intensive care units for monitoring patients with acute respiratory failure. Acidbase physiology and blood gas interpretation in the.
In addition to these direct measurements, bicarbonate ion may be either measured or calculated. Respiratory mechanics and introduction to respiratory. Internship survival guide 20142015 university of florida. Postresuscitation management of asphyxiated neonate. Save your documents in pdf files instantly download in pdf format or share a custom link. 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. These abg values reveal metabolic acidosis with partial compensation. Fetal carbon dioxide is removed from the arterial blood in the placenta, therefore the. Blood gas analysis is a commonly used diagnostic tool to evaluate the partial. His paco2 is lower than normal, reflecting the lungs attempt to compensate.
This interpretation should be based on a sound understanding of acidbase. Blood gas analysis is a routine procedure performed on newborn babies receiving respiratory support in the neonatal intensive care. The hydrogen ions are buffered by desaturated hemoglobin, and hco3 is transported out of the erythrocytes into the plasma figure 63. Boniface general hospital, winnipeg, manitoba, canada. Accurate interpretation of blood gases is paramount in clinical management in the nicu. Steps to abg interpretation fully compensated acidbase disorders v v normal, but 7. Describe the technique used for sampling blood from an artery. Pdf umbilical venous blood gas analysis for neonatal assessment. Acidbase balance overview the ph is a measurement of the acidity or alkalinity of the blood. The value of timely and accurate interpretation of blood gas results cannot be questioned. Possible dialysis to remove excess lactate, manipulation of ventilation settings to adjust co 2 levels, but always maintaining tissue perfusion. Colorcoding is used to help students decide whether a blood gas is normal, compensated or uncompensated acidosis or alkalosis. We use your linkedin profile and activity data to personalize ads and to show you more relevant ads.
And while the results are important drivers of clinical care, there are questions about whether arterial blood gas abg testing is always necessary or desirable in this patient population. Blood gas interpretation blood gases are obtained from arteries, veins and capillary beds to assess the acidbase status of the blood, and the amount of carbon dioxide and oxygen in the blood. Respiratory mechanics and introduction to respiratory physiology david j burchfield, md professor and chief, neonatology university of florida shands childrens hospital. Demonstrating clinical knowledge regarding abg interpretation and notifies physician appropriately. Understanding and use of blood gas analysis enables providers to interpret. These disorders are termed complex acidbase or mixed disorders. The clinical value of cord blood gas analysis lies in its ability to provide objective evidence of asphyxia. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
Abg interpretation ppt if this is your first visit, be sure to check out the faq by clicking the link above. Sampling for arterial blood gas analysis capillary blood gas sampling for neonatal and pediatric patients resources clinical practice guidelines objectives list the sites used for arterial punctures and state the benefits and hazards associated with each. Blood gas interpretation in the neonate what do you need. A 16 yo male presents to the er, obtunded, and rapid, shallow breathing, with progressive weakness over the last month. Blood gases are the most common tests done on neonates 1. Chatburn, bs, rrtnps, faarc director respiratory care department university hospitals of cleveland associate professor department of pediatrics case western reserve university cleveland, ohio mandu press ltd. Continuous regular abg monitoring and recording for trends. Both blood gas quizzes are based on information presented in my pulmonary physiology web sites, especially the four most important equations in clinical practice. In cases where blood gas values do not fall into any of the above classifications. Abg interpretation steps to abg interpretation step 1.
This document serves as a general guide for blood gas analysis bga. Interpretation of the arterial blood gas selflearning packet. To adequately use this information, one must have a basic understanding of gas transportation and acidbase physiology. A recent meta analysis has shown a good correlation of cord abg abnormalities ph neonatal pediatric lecture 2. This table is able to classify most clinical blood gas values but not all. Neonatal resuscitation 3 hypoxicischemic encephalopathy in resourceabundant settings remains unchanged, a recommendation was added to guide the use of this modality in settings where resources may limit options for some therapies.
Umbilical cord blood gas sampling is the most objective determinant of fetal. Lead placementlead placement v1 4th ics i ht tth ics right sternum. When one thinks of abg analysis, oxygenation may come to mind first. Interpretation of the blood gas by healthcare personnel is a critical step. Overview lead placement axis common abnormalities in critical care heart block b ndle branch blocksbundle branch blocks life threatening arrhythmias. This document should be read in conjunction with the disclaimer. The combination of invasive and noninvasive assessment of ventilation and oxygenation enables clinicians appropriately to modify respiratory care according to each individual babys rapidly changing clinical status.
No compensation ph not normal uncompensated mixed acidosis. Intensive care unit registered nurse resume samples and examples of curated bullet points for your resume to help you get an interview. This multiplechoice blood gas quiz is an easier version of a blood quiz posted in 2009. Step by step instructions and blood gas interpretation rules are included on the backside of the card. Procedure neonatal pediatric arterial puncture policy 7. Graph paper timings etc the graph paper that the ecg records on is standardized to run at 25mmsecond, and is marked. Easy blood gas quiz with answers, by lawrence martin, md. Analysis of paired arterial and venous specimens can give insights into the aetiology of acidosis in the newborn.
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