ABG Analysis

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The primary survey carried out in ED for Mrs. Kelly included assessment of the airway, breathing, circulation, disability, exposure, fluids, and glucose levels (utilization of A-G assessment format). The assessment of the airway showed no signs of obstruction or noisy breathing and the patient was breathing spontaneously, able to talk in full sentences. The airway assessment is done to ensure that airway is patent (Jarvis, 2012). Mrs. Kelly’s airway was open and this assessment is usually treated as a high priority because it determines the patient’s breathing adequacy and determination of agonal respirations that may lead to death (Considine and Currey, 2015). The next assessment of breathing, Mrs. Kelly’s RR 28 breaths/min, labored with …show more content…
The falling PH indicates ventilatory failure, lower PAO2 is showing the heart is decompensating, PCO2 declining shows that Mrs Kelly is hyperventilating due to hypoxia and anxiety, and falling HCO3 results reflect that the body is neutralizing which is achieved by using up various "buffering" compounds in the blood stream, to bind the acids, disallowing them from contributing to more acidity ( Gandhi and Akholkar, 2015). The low HCO3 level can be caused either by a primary metabolic acidosis or as the metabolic compensation for a respiratory alkalosis in Mrs Kelly 's case cardiogenic shock. The falling of BE also reflects this. The increased lactate which is the maker of cellular hypoxia, shows that the workload of the heart decreases, causing decreased CO which decreases oxygenation at cellular level (Wagner and Hardin-Pierce, 2014). Further the aerobic metabolism kicks in causing increased in lactate. For Mrs Kelly, the acidosis is likely to be metabolic in origin, given the depressed HCO3− concentration of 19 mmol/L, BE of −9.0 mmol/L. Failure to have an appropriate respiratory response to metabolic acidosis represents a failure of airway and/or breathing (Wagner and Hardin-Pierce,

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