4/7/2023 0 Comments Abgs made easy pdf![]() It occurs as a result of alveolar hypoventilation, which prevents the patient from being able to adequately oxygenate and eliminate CO 2 from their blood. Type 1 respiratory failure involves hypoxaemia (PaO 2 6.0 kPa / 45mmHg). patients with chronic obstructive pulmonary disease).³ Hypoxaemia They are suitable for all patients needing a known concentration of oxygen, but 24% and 28% Venturi masks are particularly suited to those at risk of carbon dioxide retention (e.g. Venturi masks are available in the following concentrations: 24%, 28%, 35%, 40% and 60%. Venturi masksĪ Venturi mask will give an accurate concentration of oxygen to the patient regardless of the oxygen flow rate (the minimum suggested flow rate is written on each). These masks are most suitable for trauma and emergency use where carbon dioxide retention is unlikely. Reservoir masks deliver oxygen at concentrations between 60% and 90% when used at a flow rate of 10–15 l/min.³ The concentration is not accurate and will depend on the flow of oxygen as well as the patient’s breathing pattern. These masks should not be used with flow rates less than 5L/min.³ Reservoir mask (also known as a non-rebreather mask) Simple face masks can deliver a maximum FiO 2 of approximately 40%-60% at a flow rate of 15L/min. The oxygen delivery of simple face masks is highly variable depending upon oxygen flow rate, the quality of the mask fit, the patient’s respiratory rate and their tidal volume. Below are some guides to various oxygen flow rates and the approximate percentage of oxygen delivered: 4 2 Nasal cannulaeĪs with all oxygen delivery devices, there is a significant amount of variability depending on the patient’s breathing rate, depth and how well the oxygen delivery device is fitted. Below is a quick reference guide, providing some approximate values for the various oxygen delivery devices and flow rates you’ll come across in practice. Oxygen delivery devices and flow ratesĪ common question is “What percentage of oxygen does this device deliver at a given flow rate?”. If the patient is receiving oxygen therapy their PaO 2 should be approximately 10kPa less than the % inspired concentration FiO 2 (so a patient on 40% oxygen would be expected to have a PaO 2 of approximately 30kPa /225mmHg). ![]() PaO 2 should be >10 kPa (75mmHg) when oxygenating on room air in a healthy patient. Your first question when looking at the ABG should be “Is this patient hypoxic?” as hypoxia is the most immediate threat to life. ![]() A ‘very low’ PaO 2 in a patient who looks completely well, is not short of breath and has normal O 2 saturations: this is likely a venous sample.A ‘normal’ PaCO 2 in a hypoxic asthmatic patient: a sign they are tiring and need ITU intervention.A ‘normal’ PaO 2 in a patient on high flow oxygen: this is abnormal as you would expect the patient to have a PaO 2 well above the normal range with this level of oxygen therapy.Below are a few examples to demonstrate how important context is when interpreting an ABG: ![]() PaCO 2: 4.7 – 6.0 kPa || 35.2 – 45 mmHgīefore getting stuck into the details of the analysis, it’s important to look at the patient’s current clinical status, as this provides essential context to the ABG result.Her latest book, "Ace the CSC®: You Can Do It!" Study Guide for the Cardiac Surgery Certification was published in March 2019.You may also be interested in our guide to performing an ABG, ABG quiz or our collection of ABG interpretation flashcards. In 2018, she published "Ace the CMC®: You Can Do It" Study Guide. In 2017, Nicole published "Ace the CCRN®: You Can Do It" Study Guide and Practice Question Book as well as well as "Ace the PCCN®: You Can Do It" Study Guide and Practice Question Book. She has taught CCRN® & PCCN® Certification Review courses for over 10 years and has helped thousands of nurses achieve certification! She strongly believes every nurse can and should be board certified in their specialty! In 2013, Nicole founded Nicole Kupchik Consulting, Inc. In 2009, she led a team that launched an award-winning Sepsis Alert System. She was part of a team who wrote one of the first protocols in the US for Therapeutic Hypothermia after cardiac arrest and has published numerous papers on the topic. She graduated from Purdue University in 1993 and in 2008 obtained a Master of Nursing as a Clinical Nurse Specialist from the University of Washington.Īfter moving to Seattle, Nicole took great interest in Resuscitation while working at Harborview Medical Center. ![]() Originally from Northwest Indiana, she worked as a traveling nurse and settled in Seattle, WA in 1998. Nicole Kupchik has been a critical care nurse for over 25 years. ![]()
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