ABG ANALYSIS
INTRODUCTION
Interpreting an arterial blood gas (ABG) is a crucial skill for Physicians, Nurses, Respiratory Therapists, and
other health care personnel. ABG interpretation is especially important in critically ill patients. The
following six-step process helps ensure a complete interpretation of every ABG. In addition, you will find
tables that list commonly encountered acid-base disorders. Many methods exist to guide the interpretation of
the ABG. This discussion does not include some methods, such as analysis of base excess or Stewart’s
strong ion difference. A summary of these techniques can be found in some of the suggested articles. It is
unclear whether these alternate methods offer clinically important advantages over the presented approach,
which is based on the “anion gap.”
DEFINITION
It is a diagnostic procedure in which a blood is obtained from an artery directly by an arterial puncture or
accessed by a way of indwelling arterial catheter
An arterial blood gas (ABG) test measures oxygen and carbon dioxide levels in blood. It also measures
body’s acid- base (pH) level, which is normally balanced when healthy.
INDICATIONS
1. Assess the ventilatory status, oxygenation and acid base status.
2. Assess the response to an intervention.
3. Regulate electrolyte therapy.
4. Establish preoperative baseline parameters
Arterial blood gas test results may show whether:
• Your lungs are getting enough oxygen
• Your lungs are removing enough carbon dioxide
• Your kidneys are working properly
• Blood draw points for ABG analysis
EQUIPMENTS
• Blood gas kit OR
• 1ml /2ml syringe
• 23-26 gauge needle
• Stopper or cap
• Alcohol swab
• Disposable gloves
• Plastic bag & crushed ice
• Vial of heparin (1:1000)
• Par code or label
• Arterial blood gas syringe
• Needles (20, 23 and 25 gauge, of different lengths)
• Alcohol wipe – 70% isopropyl
• Gauze
• Tape
• Lidocaine – with small needle/syringe for administration
• Sharps container
PROCEDURE
Local anesthetic
• The sample is routinely obtained from the radial artery and it is recognized that that the procedure causes
significant pain for the patient and that this can be markedly reduced by the use of subcutaneous local
anesthetic
PREPARATION
Position the patient’s arm preferably on a pillow for comfort with the wrist extended (20-30°)
Prepare all the equipment in the equipment tray using an aseptic non touch technique
Palpate the radial artery on the patient’s non-dominant hand (most pulsatile over the lateral anterior
aspect of the wrist)
Clean the site with an alcohol wipe for 30 seconds and allow to dry before proceeding
Wash hands again
Don gloves and apron
Prepare and administer lidocaine subcutaneously over the planned puncture site (aspirate to ensure you
are not in a blood vessel before injecting the local anesthetic)
Allow at least 60 seconds for the local anesthetic to work
Attach the needle to the ABG syringe, expel the heparin and pull the syringe plunger to the required fill
level (check with your local laboratory)
TAKING THE SAMPLE
1. Palpate the radial artery with your non-dominant hand’s index finger around 1cm proximal to the planned
puncture site (avoiding directly touching the planned puncture site that you have just cleaned).
2. Warn the patient you are going to insert the needle.
3. Holding the ABG syringe like a dart insert the ABG needle through the skin at an angle of 45° over the
point of maximal radial artery pulsation (which you identified during palpation).
4. Advance the needle into the radial artery until you observe blood flashback into the ABG syringe.
5. The syringe should then begin to self-fill in a pulsatile manner (do not pull back the syringe plunger).
6. Once the required amount of blood has been collected remove the needle and apply immediate firm
pressure over the puncture site with some gauze.
7. Engage the needle safety guard.
8. Remove the ABG needle from the syringe and discard safely into a sharps bin.
9. Place a cap onto the ABG syringe and label the sample.
10. Yourself or a colleague should continue to apply firm pressure for 3-5 minutes to reduce the risk of
hematoma formation.
TO COMPLETE THE PROCEDURE
• Dress the puncture site
• Dispose gloves and equipment into an appropriate clinical waste bin
• Wash hands
• Take the ABG sample to be analysed as soon as possible after being taken as delays longer than 10 minutes can affect
the accuracy of results.
COMPLICATIONS
• Arteriospasm
• Hematoma
• Nerve damage
• Fainting
• Other problems can include a drop in blood pressure, complaints of feeling faint, sweating or pallor that
may precede a loss of consciousness.
