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Emergency Medicine > Arterial Blood Gas > Flashcards

Arterial Blood Gas Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Information From Arterial Blood Gasses

A

Oxygenation
Ventilation
Acid/base

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2
Q

First Choice for ABGs

A

Radial artery

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3
Q

Other Possible Arteries for ABGs

A

Femoral

Brachial

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4
Q

Complications of ABGs

A

Hematoma
Arterial damage
Stinger (if you hit the nerve)

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5
Q

Normal pH Range

A

7.35-7.45

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6
Q

Normal CO2 Range

A

35-45 mmHg

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7
Q

Normal PaO2 Range

A

83-102 mmHg

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8
Q

Normal HCO3 Range

A

22-28 mmol/L

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9
Q

Normal Anion Gap Range

A

10-16 mmol/L

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10
Q

What can acidosis cause?

A

Decreased force of cardiac contraction
Decreased vascular response to catecholamines
Decreased response to the effects and action of certain medications

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11
Q

What can alkalosis interfere with?

A

Tissue oxygenation

Neurological and muscle function

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12
Q

Factors that Control pH

A 
Diet
Metabolic production of CO2
Regulation through the GI tract
Influence of other electrolyte
Buffers
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13
Q

3 Systems that Maintain Body pH

A

Chemical buffering
Respiratory center
Kidneys

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14
Q

Main Chemical Buffer

A

Carbonic acid system

H2O + CO2 -> H2CO3 -> HCO3 + H

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15
Q

What concentrations trigger the respiratory center as the respiratory buffer?

A

CO2
Carbonic acid
HCO3

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16
Q

What is altered to increase or decrease ventilation?

A

Respiratory rate

Tidal volume

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17
Q

Length of Time for the Respiratory Buffer

A

1-3 minutes

18
Q

Length of Time for the Renal Buffer

A

Hours to days

More powerful regulatory system

19
Q

Define Chemical Buffer

A

System of one or more compounds that act to resist pH changes when strong acid or base is added

20
Q

Types of Chemical Buffer Systems

A

Bicarbonate buffer system
Phosphate buffer system
Protein buffer system

21
Q

Respiratory Acidosis: pH, CO2, Causes

A

pH: down
CO2: up
Cause: hypoventilation

22
Q

Causes of Respiratory Acidosis

A 
CNS depression
Impaired muscle function
Pulmonary disorders
Massive PE
Hypoventilation
23
Q

Signs and Symptoms of Respiratory Acidosis

A 
Dyspnea
Respiratory distress
Shallow respiration
Headache
Restlessness
Confusion
Tachycardia
Dysrhythmias
24
Q

Management of Respiratory Acidosis

A

Increase the ventilation
Treat pneumothorax, pain, and CNS depression
May require mechanical ventilation

25
Q

Causes of Respiratory Alkalosis

A 
Psychological responses
Pain
Increased metabolic demands
Respiratory stimulants
CNS lesions
26
Q

Reasons for Increased Metabolic Demands

A

Fever
Sepsis
Pregnancy
Thyrotoxicosis

27
Q

Signs and Symptoms of Respiratory Alkalosis

A 
Light headedness
Numbness
Tingling
Confusion
Inability to concentrate
Blurred vision
Dysrhythmias and palpitations
Dry mouth
Diaphoresis
Tetanic spasms of the arms and legs
28
Q

Metabolic Acidosis: pH, HCO3

A

pH: low
HCO3: low

29
Q

Causes of Metabolic Acidosis

A 
Renal failure
DKA
Anaerobic metabolism
Starvation
Salicylate intoxication
Sepsis
30
Q

Signs and Symptoms of Metabolic Acidosis

A 
Headache
Confusion and restlessness progressing to lethargy
Stupor or coma
Dysrhythmias
Kussmaul's respirations
Warm, flushed skin
N/V
31
Q

Management of Metabolic Acidosis

A 
Treat the cause
Hypoxia will produce metabolic acids
Restore tissue perfusion
Use of bicarbonate if indicated
Hydration
32
Q

Metabolic Alkalosis: pH, HCO3

A

pH: high
HCO3: high

33
Q

Causes of Metabolic Alkalosis

A 
Ingestion of excess antacids
Excess use of bicarbonate
Use of lactate in dialysis
Protracted vomiting
Gastric suction
Hypochloremia
Excess use of diuretics
High levels of aldosterone
34
Q

Signs and Symptoms of Metabolic Alkalosis

A 
Dizziness
Lethargy Disorientation
Seizures
Coma
Weakness
Muscle twitching
Muscle cramps & tetany
N/V
Respiratory depression
35
Q

Define Base Excess

A

Calculated value estimates that metabolic component of an acid/base abnormality

36
Q

How much of Cl is reabsorbed under normal pH conditions?

A

99%

37
Q

What happens to Cl- reabsorption when acidosis is present?

A

Fewer ions are reabsorbed

38
Q

Anion Gap Equation

A

Anion gap = Na - (Cl + bicarb)

39
Q

Define Partial Compensation

A

pH remains outside the normal range

40
Q

Define Full Compensation

A

pH has returned within the normal range

41
Q

Compensation in Primary Respiratory Acidosis

A

Increased PaCO2
Decreased pH
Increased HCO3

Emergency Medicine (17 decks)

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