Easy way to remember ABG's?

DCJ3 · Feb 23, 2006

This is how I learned it...

ROME:

Respiratory= Opposite:

- pH is high, PCO2 is down (Alkalosis).

- pH is low, PCO2 is up (Acidosis).

Metabolic= Equal:

- pH is high, HCO3 is high (Alkalosis).

- pH is low, HCO3 is low (Acidosis).

HTH,

B.

Possum · Feb 23, 2006

thank you for that!!!

DecafMom · Feb 24, 2006

DCJ3 said:
This is how I learned it...
ROME:
Respiratory= Opposite:
- pH is high, PCO2 is down (Alkalosis).
- pH is low, PCO2 is up (Acidosis).
Metabolic= Equal:
- pH is high, HCO3 is high (Alkalosis).
- pH is low, HCO3 is low (Acidosis).
HTH,
B.

Wish I had asked last year when we were doing ABGs. I had the hardest time trying to remember. Thanks for sharing!!

SerenityR.N., BSN, RN · Feb 24, 2006

DCJ3 said:
This is how I learned it...
ROME:
Respiratory= Opposite:
- pH is high, PCO2 is down (Alkalosis).
- pH is low, PCO2 is up (Acidosis).
Metabolic= Equal:
- pH is high, HCO3 is high (Alkalosis).
- pH is low, HCO3 is low (Acidosis).
HTH,
B.

This is so ccol! I never thought of it like that! i was so mixed up. But with this, as long as i know the norm i should be fine. Thank you so much.

crb613, BSN, RN · Feb 24, 2006

DCJ3 said:
This is how I learned it...
ROME:
Respiratory= Opposite:
· pH is high, PCO2 is down (Alkalosis).
· pH is low, PCO2 is up (Acidosis).
Metabolic= Equal:
· pH is high, HCO3 is high (Alkalosis).
· pH is low, HCO3 is low (Acidosis).
HTH,
B.

This is how I learned it too.

truern · Feb 24, 2006

We just went over this today in lecture, and my instructor made it SOOOOO simple.

Draw a grid like a tic-tac-toe board. Label the columns across the top Acid, Normal, and Alkalotic. Down the left side label the rows pH, PaCO2, and HCO3. Fill in the grid....first row is 7.45. Those are values for pH. Then fill in the second row with >45, 35-45, and 26. Those represent HCO3. Okay, now look at your ABG lab report. Say the pH was 7.49, the PaCO2 was 48, and the bicarb was 37. Tie in those values in your grid. You should have 7.49 under alkalotic, 48 under acid, and 37 under alkalotic. Look at the pH first to see if it's acidic, normal, or alkalotic. The next value in the same column will tell you if it's respiratory or metabolic (PaCO2 reflects respiratory, and HCO3 reflects metabolic). It's as simple as which column has two values in it :)

Acid Normal Alk

_____________________________________

pH 7.45

_____________________________________

PaCO2 >45 35.45

_____________________________________

HCO3 26

Then you can get into whether or not it's compensated :)

Daye · Feb 25, 2006

This is the formula I use and it hasn't failed me yet! I thought I would hate ABG's ended up loving them when I learned to tic-tac-toe!:roll

gwenith, BSN, RN · Feb 25, 2006

I have an easy way that does NOT rely on remembering which is up and which is down but DOES require a little math.

It is a rule of thumb.

For every 1 millimeter change in the PCO2 the PH will change by .01 in the opposite direction.

So, if the center of normal for PH is 7.40 and the centre of normal for PCO2 is 40 then if your PCO2 rises to 60 you would expect the PH to be 7.2. If it is not then you have some metabolic compensation occuring.

truern · Feb 25, 2006

Thanks, VickyRN...that's exactly what I was trying to say

happynewLPN · Oct 15, 2008

I use both the tic tac toe method along with the ROME acronym and it's never failed me yet. Also, the scenario that goes along with your patient will lead you to the answer.

dltlmt · Oct 28, 2008

I have a test tomorrow! I've heard this rocks for Arterial Blood Gases! I'll let you know! HUGS! HEALTH! HAPPINESS!