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So you are an intelligent RT student or RN who wishes to learn more about how to
interpret ABGs. That in mind, and based on popular demand, here is ABG
interpretations made easy
(For simplicity reasons I will only refer to the three basic ABG values in this post: pH
(acid base balance), CO2 (carbon dioxide) and HcO3 (bicarbonate).
All you have to do is memorize four basic questions and then answer them in order:
A. Is the ABG normal? If all of them are, then you have a normal ABG and you can stop
here. If any one of the values is out of the normal range, then you must move on to the
next question.
B. Is the pH Acidotic or Alkalotic?: To determine this you look only at the pH.
In this sense, you match the pH with HcO3 and CO2. If the pH matches with the CO2,
you have respiratory. If the pH matches with the HcO3, you have metabolic.
What do you have here? All the number are within normal range, so you have a normal
ABG.
That was easy enough. You need to go no further in analyzing this ABG.
C. Is is metabolic or respiratory? Since the pH is acidotic and the CO2 also acidotic, then
you have respiratory acidosis.
A. Is the ABG normal? You can see right away that both CO2 and HcO3 are out of the
normal range, so you move on to the next question.
C. Is the cause respiratory or metabolic?: The pH is acidotic and the CO2 is also acidotic,
so you have respiratory acidosis.
A. Is the ABG normal? No. Some of the values are outside the normal ranges.
B. Is it acidotic or alkalotic? The pH is greater than 7.41, so it is alkalotic.
C. Is the cause respiratory or metabolic?: You know the pH is alkalotic, so you look for
the matching value. The HcO3 is alkalotic, so it matches the pH. So, what you have is a
metabolic problem.
A. Is the ABG normal? No, pH and CO2 are both out of the normal range.
C. Is is respiratory or metabolic? Since the pH is alkalotic and the CO2 is also alkalotic,
you have a respiratory problem
Once you practice these for a few days or weeks, you will be able to do these
automatically in your head in only a few seconds just by looking at the numbers.