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How to do ABG analysis incredibly quick and accurate? Follow the following steps:
Step I. Remember the Normal Values
Step II. Look at the pH. Does it indicate presence of academia, or alkalemia, or normal pH?
MIDDLE RANGE
7.40
Acid ← 7.35 ---------------------------------------7.45 → Base
(ACIDOSIS) (ALKALOSIS)
MIDDLE RANGE
40
Please do these exercises. Identify whether the following values represent RESPIRATORY ACIDOSIS, RESPIRATORY
ALKALOSIS, or NORMAL values.
1. pH 7.32
pCO2 50 __________________________
2. pH 7.50
pCO2 30 __________________________
3. pH 7.37
pCO2 41 __________________________
Please do these exercises. Identify whether the following values represent METABOLIC ACIDOSIS, METABOLIC ALKALOSIS, or
NORMAL values.
1. pH 7.28
HCO3 18 ______________________
2. pH 7.52
HCO3 32 ______________________
3. pH 7.43
HCO3 25 ______________________
4. pH 7.30
HCO3 20 ______________________
5. pH 7.48
HCO3 28 ______________________
The change that matches the pH is the primary ACID – BASE DISTURBANCE.
b. pH ↓ ACIDOSIS
HCO3 ↓ ACIDOSIS METABOLIC ACIDOSIS
Check on these…
1. Respiratory Acid – Base Imbalances
Respiratory Opposite means: the directions of pH and PaCO2 are opposite. Look at these examples.
pH ↓ RESPIRATORY
PaCO2 ↑ ACIDOSIS
pH ↑ RESPIRATORY
PaCO2 ↓ ALKALOSIS
pH ↓ RESPIRATORY
HCO3 ↓ ACIDOSIS
2. Metabolic
pH HCO3
Acidosis low low Same
Alkalosis high high directions
Now, you’re ready to do the following exercises. Indicate in the following spaces provided whether the values represent ACIDOSIS,
ALKALOSIS, or NORMAL.
1. pH 7.5 ________________________
PaCO2 32 ________________________
HCO3 26 ________________________
2. pH 7.54 ________________________
PaCO2 60 ________________________
HCO3 32 ________________________
3. pH 7.30 ________________________
PaCO2 52 ________________________
HCO3 30 ________________________
4. pH 7.32 ________________________
PaCO2 30 ________________________
HCO3 18 ________________________
How are you doing at this point? If you’re doing well, then proceed to the next step.
E.g.
PaCO2 high (ACIDOSIS) HCO3 high (ALKALOSIS)
PaCO2 low (ALKALOSIS) HCO3 low (ACIDOSIS)
1. When the acid-base balance is compensated, but the pH is still ABNORMAL: PARTIAL COMPENSATION.
2. When the acid-base is balance compensated, and the pH is NORMAL : COMPLETE COMPENSATION.
When the CO2 and HCO3 levels more towards opposite directions. (The problem is worsened.)
E.g.
PaCO2 high (ACIDOSIS) HCO3 high (ALKALOSIS)
Or when PaCO2 is abnormal and HCO3 remains normal and vise versa, the acid-base imbalance is also uncompensated
Remember, retention of the knowledge is 90% when you say it and you do it.
Place a check (√) in the appropriate column indicating whether the pH is Normal, ACIDOTIC, or ALKALOTIC.
pH Normal Acidosis Alkalosis
1. 7.37
2. 7.61
3. 7.19
4. 7.50
5. 7.30
6. 7.41
7. 7.48
8. 7.28
9. 7.35
10. 7.52
Check (√) whether the following data represent RESPIRATORY ACIDOSIS, RESPIRATORY ALKALOSIS or NORMAL
pH PaCO2 Respiratory Acidosis Respiratory Alkalosis Normal
11. 7.20
12. 7.52
13. 7.33
14. 7.48
15. 7.38
Check (√) whether the following data represent METABOLIC ACIDOSIS, METABOLIC ALKALOSIS or NORMAL
pH HCO3 BE Metabolic Acidosis Metabolic Alkalosis Normal
16. 7.26 19 -6
17. 7.42 24 0
18. 7.42 15 -8
19. 7.54 35 +6
20. 7.51 30 +4
Identify the primary acid – base disturbance if any, and indicate whether compensation is partial or complete or uncompensated acid –
base imbalance.
21. pH 7.5
PaCO2 31
HCO3 26 ________________________________________________
22. pH 7.38
PaCO2 32
HCO3 19 ________________________________________________
23. pH 7.24
PaCO2 60
HCO3 32 ________________________________________________
24. pH 7.41
PaCO2 30
HCO3 18 ________________________________________________
25. pH 7.5
PaCO2 42
HCO3 33 ________________________________________________
Congratulations!
You have learned a crucial knowledge towards excellence in CARE!