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by Shantas

Updated Nov 23, 2007 at 01:29 AM by Shantas

Ok guys I need some help:
I had this patient today who has been sufferring from Respiretory Acidosis and the doctor put her on a bi pap machine. The ABG has been out of walk all day.
In the evening her husband came to visit her and ask me why his wife was on a ventilator.....I told him it was a bipap machine and it was giving her oxygen....then he ask me to tell him why his wife needed bi-pap, what was going on with her oxygen...so on and so forth....!!!!
I tried my best to explain to him about ABG's but I did not think I got through to him
Can any one have any idea whats the best way to explain ABG's to a lay man??

[JustaGypsy]

Re: How would you explain a family member the concept of ABG

My most effective explanation was always that it tells us exactly how well the lungs are getting oxygen into the blood for the body to use.

[patwil73]

Re: How would you explain a family member the concept of ABG

ABG's for the nurse:

In respiratory acidosis the patient is not blowing off enough carbon dioxide. As the CO2 level rises in the body it diminishes the respiratory drive causing the patient to breathe even less and more shallow. This further increases the CO2 level. The higher it gets the lower (or more acidotic) the PH gets. If you get below 7 your body can not sustain either it's respiratory drive or the cardiovascular system - you get an arrest.

We use Bi-pap to "force" the patient to take deeper breaths and receive more oxygen with each breath. This in turn forces the removal of CO2 by increasing ventilation. Essentially, there is a point where the increased CO2 causes you to breathe faster to blow it off - if the CO2 rises beyond that point you breathe slower and things get worse. If you increase the O2 at this point (by forcing air in, not just increasing the O2 received) then the CO2 level gets back to where your body will trigger the respiratory drive to increase.


For the Family:

We are using the bi-pap to get your family member to breathe deeper and increase the number of breaths she takes in order to correct her carbon dioxide level. The higher her CO2 the less she breathes, so we want it to come down so she will breathe better on her own. Unfortunately we have only two options to increase the depth and rate of her breathing - the 1st is the bi-pap which forces air into her lungs when she takes a breath. The 2nd is a ventilator which is a tube down her throat and mainly breathes for her. We are watching her CO2 level closely and when she is able to breathe effectively on her own, the doctor will be able to take her off this machine.


Hope this helps,

Pat

[Christie RN2006]

Re: How would you explain a family member the concept of ABG

A lot of the families we get have very little to no medical knowledge beyond what they see on tv, so we have to try to explain things in very simple terms. How in depth I get depends on if I sense the family is really understanding what I am saying. If they give you a blank stare, then they have no idea what you are talking about.

A lot of times I just explain that we look at the ABG results to see how well the patient is breathing. I explain that we can't always tell how well they are breathing by just looking at them, sometimes we need to know if their lungs are working correctly and one of the ways to do that is to look at the ABG results.

I try to explain that we use bipap when the patient isn't breathing as well as they should be and that the machine is going to give them some extra help and the oxygen that they need at that moment. I try to explain how the bipap helps to push air into the lungs so that the patient doesn't have to work so hard to breathe.

Some families might grasp what you are saying, so then you can go a little bit more in depth, but those are the basic explanations I start with. On the other hand some families will never fully understand what is going on no matter how simple the explanation.

[GilaRN]

Re: How would you explain a family member the concept of ABG

Huh? Keep it simple. BIPAP is a machine that will help her breath. It may prevent her from being placed on a ventilator.Still confused? You need a tube down your throat for a ventilator. No tube down the throat,no ventilator. We do the ABG because it is can give us allot of information about how well she is breathing.

[NewRN2008]

Re: How would you explain a family member the concept of ABG

Tell them about the O2 sat monitor. then just tell them that this blood test is more specific about her O2 status. The best way we can tell this is by the blood that is in an artery because that is "freshly" oxygenated blood. We want to make sure that she is doing her best before she goes home and this is the most accurate test. If you can, heck, give him a copy of the ABG results and write a simple explanation if you can about each one. I dont mean and essay or even more than 3 sentances, but notes for the family. ESP for those numbers we are really watching. That way they understand and can write things themselves, in their terminology.
GL!
I love teaching families, i just hope i can make enough time when i become an adult and have a real job!
GL!
-H-

[loricatus]

Re: How would you explain a family member the concept of ABG

I think that the simpliest way to explain it would be to say that: we take circulatiing blood and test it to see how much oxygen got through to it from the lungs. In your wife's case, normal breathing showed that not enough oxygen was passing through her lungs and into the blood (where it needs to be to get oxygen throughout her body). The BIPAP machine is designed to give the oxygen a push (under pressure) so more gets pushed into her circulation from the lungs.
If the patient's husband wants to know more, he'll ask and you can go into more depth based on the questions asked. Sometimes, families just want to hear the basics and are satisfied with that.

[Daytonite]

This is the age of the Internet! There are some terrific patient teaching materials that some medical centers, and specifically, our government, has put online for consumers. I posted a list of these for the students because they are easy for them to read in getting initial information about diseases, treatments, procedures and tests. You can print out this list to have it for your own, just go to some of these sites to pull up and print out the information for families. Not too long ago I pulled up information about BiPAP and C-PAP for a student and posted links to information about it (http://allnurses.com/forums/f205/int...on-260944.html - see post #2). Right off the top of my head the two sites I would go to first are Medline Plus and the A.D.A.M. Healthcare Center. The A.D.A.M. site includes very nice drawings of anatomy where relevant. Here is the link to that list:

• http://allnurses.com/forums/f205/medical-disease-information-treatment-procedures-test-reference-websites-258109.html - Medical Disease Information/Treatment/Procedures/Test Reference Websites

[chare]

Re: How would you explain a family member the concept of ABG

When I teach airway/breathing stations I start with 2 simple rules: Oxygen goes in, and carbon dioxide goes out. I do this to emphasize the two separate components of the breathing process: Oxygenation and ventilation. Interventions affecting one will have little to no effect on the other. In the setting of mechanical ventilation (which Bi PAP is) there are 4 interventions that can affect this process.

Increasing the FiO2 that the person is breathing or adding pressure during the respiratory cycle to help keep the alveoli inflated will increase oxygenation. Neither of these interventions will greatly affect the PCO2 level.

Increasing the minute volume by either increasing the respiratory rate or increasing the tidal volume, or both will increase ventilation, or “blowing off” CO2.

You can also use the oxygen in/CO2 out with the patient and family when you are explaining the ABG. Most people have a really good understanding of first component, however unless they have a family member with COPD most aren’t aware of the CO2 portion. Then explain that the ABG lets you know not only how well the patient is doing both, but also how well they are compensating.

http://www.emedicine.com/med/topic2008.htm
http://www.emedicine.com/med/TOPIC2011.HTM
http://people.eku.edu/ritchisong/RITCHISO/301notes6.htm
http://www.bmj.com/cgi/content/full/317/7167/1213
http://www.edu.rcsed.ac.uk/lectures/lt8.htm
http://www.madsci.com/manu/indexgas.htm

[elizabells]

Re: How would you explain a family member the concept of ABG

In our NICU I've encountered parents with all levels of understanding, from the "the blood tests shows us how well the baby is breathing" to the EMT dad to whom I tell the actual PCO2 and what vent changes we made because of it. We don't use BiPap, but with CPAP I always make sure to tell the parents that the pt is breathing on her own, the machine is not breathing for her, it's just helping keep her lungs open.