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An arterial blood gas (ABG) test measures the acidity (pH) and the levels of oxygen
and carbon dioxide in the blood from an artery. This test is used to check how well
your lungs are able to move oxygen into the blood and remove carbon dioxide from
the blood.
As blood passes through your lungs, oxygen moves into the blood while carbon
dioxide moves out of the blood into the lungs. An ABG test uses blood drawn from
an artery, where the oxygen and carbon dioxide levels can be measured before they
enter body tissues. An ABG measures:
1 Partial pressure of oxygen (PaO2). This measures the pressure of oxygen
dissolved in the blood and how well oxygen is able to move from the
airspace of the lungs into the blood.
2 Partial pressure of carbon dioxide (PaCO2). This measures the pressure of
carbon dioxide dissolved in the blood and how well carbon dioxide is able to
move out of the body.
3 pH. The pH measures hydrogen ions (H+) in blood. The pH of blood is usually
between 7.35 and 7.45. A pH of less than 7.0 is called acid and a pH greater
than 7.0 is called basic (alkaline). So blood is slightly basic.
4 Bicarbonate (HCO3). Bicarbonate is a chemical (buffer) that keeps the pH of
blood from becoming too acidic or too basic.
5 Oxygen content (O2CT) and oxygen saturation (O2Sat) values. O2 content
measures the amount of oxygen in the blood. Oxygen saturation measures
how much of the hemoglobin in the red blood cells is carrying oxygen (O2).
Why It Is Done
An arterial blood gas (ABG) test is done to:
6 Check for severe breathing problems and lung diseases, such asasthma,
cystic fibrosis, or chronic obstructive pulmonary disease (COPD).
7 See how well treatment for lung diseases is working.
8 Find out if you need extra oxygen or help with breathing (mechanical
ventilation).
9 Find out if you are receiving the right amount of oxygen when you are using
How To Prepare
Tell your doctor if you:
Have had bleeding problems or take blood thinners, such as aspirin or warfarin
(Coumadin).
Are taking any medicines.
Are allergic to any medicines, such as those used to numb the skin
(anesthetics).
If you are on oxygen therapy, the oxygen may be turned off for 20 minutes
before the blood test. This is called a "room air" test. If you can't breathe
without the oxygen, the oxygen will not be turned off.
Talk to your doctor about any concerns you have regarding the need for the test, its
risks, how it will be done, or what the results may mean. To help you understand the
importance of this test, fill out the medical test information form.
How It Is Done
A sample of blood from an artery is usually taken from the inside of the wrist (radial
artery), but it can also be taken from an artery in the groin (femoral artery) or on
the inside of the arm above the elbow crease (brachial artery). You will be seated
with your arm extended and your wrist resting on a small pillow. The health
professional drawing the blood may rotate your hand back and forth and feel for a
pulse in your wrist.
A procedure called the Allen test may be done to ensure that blood flow to your
hand is normal. An arterial blood gas (ABG) test will not be done on an arm used for
dialysis or if there is an infection or inflammation in the area of the puncture site.
The health professional taking a sample of your blood will:
Clean the needle site with alcohol. You may be given an injection oflocal
How It Feels
Collecting blood from an artery is more painful than collecting it from a vein
because the arteries are deeper and are protected by nerves.
Most people feel a brief, sharp pain as the needle to collect the blood sample
enters the artery. If you are given a local anesthetic, you may feel nothing at all
from the needle puncture, or you may feel a brief sting or pinch as the needle
goes through the skin.
You may feel more pain if the person drawing your blood has a hard time
finding your artery, your artery is narrowed, or if you are very sensitive to pain.
Risks
There is little chance of a problem from having a blood sample taken from an artery.
You may get a small bruise at the site. You can lower the chance of bruising by
keeping pressure on the site for at least 10 minutes after the needle is removed
(longer if you have bleeding problems or take blood thinners).
You may feel lightheaded, faint, dizzy, or nauseated while the blood is being
drawn from your artery.
Ongoing bleeding can be a problem for people with bleeding disorders. Aspirin,
warfarin (Coumadin), and other blood-thinning medicines can make bleeding
more likely. If you have bleeding or clotting problems, or if you take bloodthinning medicine, tell your doctor before your blood sample is taken.
On rare occasions, the needle may damage a nerve or the artery, causing the
artery to become blocked.
Though problems are rare, be careful with the arm or leg that had the blood
draw. Do not lift or carry objects for about 24 hours after you have had blood
drawn from an artery.
Results
An arterial blood gas (ABG) test measures the acidity (pH) and levels of oxygen and
carbon dioxide in the blood.
Normal
The normal values listed herecalled a reference rangeare just a guide. These
ranges vary from lab to lab and depend upon the elevation above sea level. Your lab
may have a different range for what's normal. Your lab report should contain the
range your lab uses. Also, your doctor will evaluate your results based on your
health and other factors. This means that a value that falls outside the normal
values listed here may still be normal for you or your lab.
Results continued...
Results are usually available right away.
Arterial blood gases (at sea level and breathing room air) 1
pH:
Bicarbonate (HCO3):
Oxygen content (O2CT):
Oxygen saturation (O2Sat):
7.357.45
2226 mEq/L (2226 mmol/L)
1522 mL per 100 mL of blood (6.69.7 mmol/L)
95%100% (0.951.00)
The normal values for children may differ from the adult values listed here.
The concentration of oxygen being breathed, called the fraction of inhaled oxygen
(FiO2), is also usually reported. This is only useful if you are receiving oxygen
Allens Test:
The blood supply to your hand normally comes from two arteries: the radial artery
and the ulnar artery. Before drawing blood for an arterial blood gas test, your
health professional will make sure that both arteries are open and working
correctly. A procedure called the Allen test may be used to find out if the blood flow
Normal (positive)
Abnormal (negative)
If your hand remains pale and cold, the Allen test will then be performed on your
other hand. If your other hand also remains pale, the blood often will be collected
from another artery, usually in the groin or elbow crease.
In medicine, the Modified Allen's test, also the Modified Allen test,
The hand is elevated and the patient/person is asked to make a fist for about
30 seconds.
Pressure is applied over the ulnar and the radial arteries so as to occlude
both of them.
Still elevated, the hand is then opened. It should appear blanched (pallor can
be observed at the finger nails).
The Allen's test is testing for abnormal circulation. If color returns as described
above, the Allen's test is considered to be "Negative" (abnormal circulation is
NOT present). If color fails to return, the test is considered "Positive" (abnormal
circulation is present) and theulnar artery supply to the hand is not sufficient. The
radial artery therefore cannot be safely pricked/ cannulated.
http://fitsweb.uchc.edu/student/selectives/TimurGraham/Modified_Allen%27s_Test.html
Instruct the patient to clench his or her fist; if the patient is unable to do this, close the
person's hand tightly.
Using your fingers, apply occlusive pressure to both the ulnar and radial arteries, to
obstruct blood flow to the hand.
While applying occlusive pressure to both arteries, have the patient relax his or her hand,
and check whether the palm and fingers have blanched. If this is not the case, you have
not completely occluded the arteries with your fingers.
Release the occlusive pressure on the ulnar artery only to determine whether the modified
Allen test is positive or negative.
Positive modified Allen test If the hand flushes within 5-15 seconds it indicates that the
ulnar artery has good blood flow; this normal flushing of the hand is considered to be a
positive test.
Negative modified Allen test If the hand does not flush within 5-15 seconds, it indicates
that ulnar circulation is inadequate or nonexistent; in this situation, the radial artery
supplying arterial blood to that hand should not be punctured.
Purpose
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Procedure
Patient Preparation
1 Explain the arterial blood gas analysis evaluates how well
the lungs are delivering the oxygen to the blood and
eliminating carbon dioxide.
2 Tell the patient that the test requires a blood sample.
3 Explain to the patient, who will perform the arterial
puncture, when it will occur, and where the puncture site will
be; radial, brachial, or femoral artery.
4 Inform the patient that he may not need to restrict food
and fluids.
5 Instruct the patient to breathe normally during the test,
and warn him that he may experience a brief cramping or
throbbing pain at the puncture site.
Implementation
6 Use a heparinized blood gas syringe to draw the sample.
7 Perform an arterial puncture or draw blood from an
arterial line.
8 Eliminate air from the sample, place it on ice
immediately, and prepare to transport for analysis.
9 Note the flow rate of oxygen therapy and method of
delivery.
10Note the patients rectal temperature.
Nursing Interventions