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Abstract
Nurses caring for children need to be able to understand the investigations that contribute to holistic assessment of the child. Blood gas analysis is a common investigation in critical care settings but is also used during stabilisation or preparation for transfer to critical care of children who are acutely ill. In this article the indications for arterial blood gas analysis are discussed and patient groups that may benefit from this investigation identified. The basic science behind acid-base balance and its impact on homeostasis are described. A simple guide to interpreting arterial blood gas results and the principles surrounding care of a child's arterial line are also addressed.
Key words
* Intensive care: children
* Diagnostic tests
* Respiratory distress
Arterial blood gas analysis is a valuable tool in the management of the acutely or critically ill child. Nurses working in critical care environments will be familiar with the implications of this investigation.
Those working in other settings and caring for children during stabilisation or preparation for transfer to a critical care environment also need knowledge and skills related to arterial blood gas analysis so they can contribute to timely, safe and evidence-based care. The nurse may be expected to:
* Obtain and process the blood sample.
* Identify abnormalities and the significance of the results.
* Assess the need for urgent medical attention (Woodrow 2004).
In this article the indications for arterial blood gas (ABG) analysis are discussed and patient groups that may benefit from this investigation identified. The basic science behind acid-base balance and its impact on homeostasis are described. A simple guide to interpreting ABG analysis and the principles surrounding care of a child's arterial line are also addressed.
Indications for arterial sampling
Analysis of arterial blood can assist in the assessment of the child's respiratory and metabolic systems. However, it should not be relied on in isolation when making clinical decisions: a thorough systematic clinical assessment of the child with regular re-evaluation can be far more beneficial than the information obtained from a single arterial blood gas result (British Medical Journal 2005).
Box 1 lists the types of conditions seen in children that may warrant taking a blood sample. Arterial sampling is a painful procedure and needs careful...