ABG ROME Flowchart
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When I ask nursing students what they struggle with most often, the most common answer is pharmacology, but a close second is ABGs.
I admit, ABGs can be confusing.
As an ICU nurse I learned to love ABGs and the information I was able to gather on my patient and the therapies we were providing based on the blood gas results.
The lowest pH I remember seeing on the floor was 7.1 (6.8 is considered incompatible with life). Intensive ventilator management and provision of appropriate fluids, medications, and dialysis can work wonders for patients with extreme acid-base imbalances however this patient did not survive as he was in severe ARDS compounded by extreme sepsis.
I remember that night vividly.
I walked onto the unit and everyone kinda smiled. . . they all knew I enjoyed taking the most complex patients.
This patient was on 10 IV medications, dialysis, ventilator, and even the slightest movement would cause his O2 sats (despite being on 100% O2 and PEEP of 10) to drop drastically.
The decision to withdraw care fell on his young daughter and she struggled greatly with the burden. He did eventually pass from cardiac arrest despite all of the medical care we were providing as his body was simply unable to rebound.
Okay. . .
I realize that is a LONG story to get to a simple point.
ABGs are important to understand. While you should trust and rely on your RTs it is important to know what you are looking at on the VENT and through your patient assessment so you can relay that to the RT and provider.
Today's cheatsheet will provide you with a simple flowchart to determine what sort of acid-base imbalance a patient is experiencing.
Simply start at the top and work your way through.
