writing some discussion questions for a short resident teaching session this afternoon on ABG & VBG analysis. answers & explanation to follow later this evening... ABGs are presented as pH/pCO2/pO2/bicarb (1/6)
A woman with history of heart failure, COPD, and recent international plane travel presents with dyspnea to the ED. ABG shows 7.52/29/65/23. What does this test reveal about her diagnosis? (2/6)
A man with COPD presents with initial ABG 7.25/70/55/30. His mentation is fine, but he has substantial work of breathing with RR 35. After two hours of BiPAP he is feeling & looking better with RR 27/min. Repeat ABG shows 7.23/74/130/30. What is best management? (3/6)
A man presents with history of productive cough, fever, and dyspnea. His PMH is notable for severe OSA/OHS and chronic use of high-dose hydromorphone for back pain. Currently he is sleepy but easily arousible. ABG shows 7.2/105/65/40. What does this test mean? (4/6)
A COPD patient is about to leave ICU when she gets a bit sleepy. ABG shows 7.04/120/53/31 with a good pulse oximetry waveform showing saturation of 98% on 4 liters. Which of the following is most accurate? (5/6)
my answers w/ discussion & links for further reading. bottom line: ABGs aren’t nearly as helpful as commonly believed & we should get fewer of them. and when we actually *do* need blood gas analysis, VBG is generally fine (6/6) #zentensivist emcrit.org/squirt/abg/
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