Arterial blood gas (APACHE): Difference between revisions

This article is about ABG ('''A'''rterial''' B'''lood '''G'''as) for [[APACHE]].  

All arterial blood gas results ([[FiO2]],  [[PO2]],  [[CO2]] & [[PH]]) should be obtain from the '''SAME SPECIMEN'''.

*An ABG result is preferred, but if '''no''' ABG available during the first 24 hours in ICU then select the worst '''[[serum CO2]]'''

Select the '''worst deviation from normal''' Arterial Blood Gases (ABG) in the first 24 hours of ICU admission as outlined on the [[APACHE Scoring table]]. '''Do not use venous gases.'''

IF [[FiO2]] ≥ 50% - Base the selection of the '''worst''' ABG on the '''worst''' [[AaDO2]] (you can use the [[ABG Helper button]] to help determine this.

== ABG Helper ==

There is an ABG helper in the [[CCMDB.mdb]]. You can enter two or more blood gas values and the program will show the number of apache points each value generates, whether it is the pO2, aADO2 or the ph. Choose the individual blood gas that gives the most apache points. Only one complete blood gas can be used (Do not pick a pH from one blood gas and other values from another blood gas).

== ABGs as part of apnea tests ==

Are '''abgs''' taken during an apnea test included or excluded in the calculation of apache scores? [[Apache II General Collection Guidelines]]--[[User:LBilesky|LBilesky]] 13:38, 2016 November 15 (CST)

*This is a quote from the APACHE instructions.

**Keep in mind the diagnosis and try not to include iatrogenically enhanced symptoms, e.g. BP severely high due to inotropes or decreased LOC due to sedation.

*Aware of the guidelines. The question isn't asking about iatrogenically affected BP or iatrogenically enhanced neurological symptoms. I was asking about the '''ABG's''' taken during an apnea test. The patients are not sedated. They are neurologically impaired by the critical illness that brought them to the ICU. The question is do we include or exclude the''' abg''' result taken during an apnea test in our apache score done in the first 24 hours if it is the worst value? [[User:GHall|GHall]] 06:51, 2016 November 17 (CST)

**I would include it, because the poor numbers are a reflection of the patient's neurological status when we take away the support of the ventilator. It is a more accurate reflection of the patient's status than the ABG's we take when we are controlling the patient's minute ventilation.[[User:Mlagadi|Mlagadi]] 08:20, 2016 November 17 (CST)

 

{{Potential Change}} [[Venous blood gas]] count in addition to ABG count, approval obtaining Steering November 2.15 to count as separate.

**Trish will add to priority list.[[User:TOstryzniuk|Trish Ostryzniuk]] 16:20, 2015 December 10 (CST)

[[Category:ABG|*]]