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Egan's 18
ABG's
| How can tissue O2 be measured | By invasive probes-Tissue Oxygen (Pt)2) monitor, inserted directly into organs, tissue, and body fluids. |
| How do you prevent pre-anlytical errors in ABG samples? | Make sure the sample is: Obtained anaerobically, properly anticoagulated, bubbles removed, analyzed within 10 to 30 minutes |
| How is CO2 transported? | 45-55 ml of CO2 per 1 dl blood is transported by ionized bicarb, dissolved in plasma, and plasma protein transport. |
| How much blood is needed for an adequate ABG sample? | 0.5 mL of blood. Usually enough to perform two tests. |
| For accurate ABG results what are the components of quality control? | Record Keeping Performance validation Preventative maintenance and function checks Automated Calibration/Verification Internal Statistical quality control External quality control (proficiency testing Remedial action |
| Intra-arterial (In Vivo) continuous blood gas analysis is beneficial how? | Real time monitoring Reduction in therapeutic decision making time Less blood loss Lower infection risk Improved accuracy Elimination of specimen transpor |
| Invasive procedures are | Insertion of a monitoring device into a patient |
| Laboratory Analysis is | discrete measurements of fluids or tissue that has been removed from the patient |
| Monitoring is defined as | An ongoing process by which clinicians obtain and evaluate dynamic physiological processes in a timely manner (bedside) |
| Noninvasive procedures are | external monitoring without insertion of devices INTO the patient |
| Possible anatomical sites for ABG's | Radial Brachial Femoral Posterior Tibial Dorsalis Pedis |
| Pressure values for osygenation | PaO2 80-100 mmHg normal 60-80 mmHg mildly hypoxemic 40-59 mmHg moderately hypoxemic < 40 mmHg severely hypoxemic SaO2 95-100% Normal CaO2 18-20 % Normal |
| Procedure for initiating indwelling catheterization | First sample of indwelling catherter would be a waste sample |
| Reasons for drawing an ABG | Sudden, unexplained dyspnea Acute shortness of breath/tachypnea Abnormal breath sounds Cyanosis Heavy sue of accessory muscles Changes in ventilator settings CPR Diffuse infiltrates in Chest Xray Sudden Cardiac arrhythmias Acute hypotension |
| What are common technical errors associated with capillary blood samplig? | Inadequate warming and squeezing of punture site. Squeezing the puncture site may result in venous and lymphatic contamination of the sample |
| What are secondary values to ABGs that need to be CALCULATED? | Bicarbonate (HCO3) Base Excess (BE) or deficit Hemoglobin saturation (HbO2) |
| What are the 2 most important factors influencing accuracy of transcutaneous measurements? | Age and perfusion status |
| What are the benefits of indwelling catheters? (ie. A-Line) | Provides ready access for blood sampling Allows for continuous monitoring of vascular pressures. |
| What are two site locations for indwelling catheters? | Normal routes are preipheral arteries (radial, brachial, pedal), femoral artery, central vein, and pulmonary artery. |
| What are two techniques of capnometry? | Mainstream technique places an analysis chamber in patients breathing circuit. Sidestream technique pumps small volume of gas from circut into nearby analyzer. |
| What an a good capillary blood gas sample provide and reflect? | Estimated arterial oxygenation and PCO2 |
| What can be used if frequent blood sampling is needed? | Arterial Cannulation |
| What can PtO2 monitors indicate? | Monitor brain tissue oxygen as an early sign of ischemia. Monitor adequacy of brain perfusion in patients with traumatic brain injury. |
| What do most bedside systems to measure FiO2 utilize? | Electrochemical principles (O2 analyzers) |
| What does Extra-arterial (Ex Vivo) blood gas analysis provide? | Eliminates all problems associated indwelling sensors. Provides quick results Determine further justification of costs and patient benefits. |
| What does oximetery measure? | Hb saturation using spectrophotometry. |
| What does transcutaneous monitoring provide? | Continuous, noninvasive estimates of PO2 and PCO2 using a skin sensor. Also PtcO2 levels. |
| What is the downfall of indwelling catheters? | Infection and thrombosis are more likely than intermittent punctures. |
| What is Hb measurements expressed as and what is its O2 capacity when compared to what is dissolved in plasma | Always expressed in grams/dl. dl=100 ml. The O2 capacity of Hb is 7x greater than what is dissolved in plasma. |
| What is hemoximetry? | Laboratory analytical procedure requiring invasive sampling of arterial blood |
Created by:
rrtruett
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