Lets Play. Values: pH (acid): < 7.35 pH (normal): 7.35 7.45 pH (base): > 7.

45

ABG Tic-Tac-Toe
> 45 35 45 < 35 HCO3 (acid): HCO3 (normal): HCO3 (base): < 22 22 26 > 26

PaCO2 (acid): PaCO2 (normal): PaCO2 (base):

ABG values: pH______________ PaCO2__________________ Acid/Normal/Base: pH_________ PaCO2__________________ Now plug in your values:

HCO3_____________________ HCO3_____________________

Acid pH PaCO2 HCO3

Normal

Base (Alkaline)

RESPIRATORY ACIDOSIS: Respiratory acidosis uncompensated: Respiratory acidosis partially compensated: Respiratory acidosis totally compensated: RESPIRATORY ALKALOSIS: Respiratory alkalosis uncompensated: Respiratory alkalosis partially compensated: Respiratory alkalosis totally compensated: METABOLIC ACIDOSIS: Metabolic acidosis uncompensated: Metabolic acidosis partially compensated: Metabolic acidosis totally compensated: METABOLIC ALKALOSIS: Metabolic alkalosis uncompensated: Metabolic alkalosis partially compensated: Metabolic alkalosis totally compensated:

pH acid ( ) pH acid ( ) pH normal pH base () pH base () pH normal pH acid ( ) pH acid ( ) pH normal pH base () pH base () pH normal

PaCO2 acid () PaCO2 acid () PaCO2 acid () PaCO2 base ( ) PaCO2 base ( ) PaCO2 base ( ) PaCO2 normal PaCO2 base ( ) PaCO2 base ( ) PaCO2 normal PaCO2 acid () PaCO2 acid ()

HCO3 normal HCO3 base () HCO3 base () HCO3 normal HCO3 acid ( ) HCO3 acid ( ) HCO3 acid ( ) HCO3 acid ( ) HCO3 acid ( ) HCO3 base () HCO3 base () HCO3 base ()

Interpretation: Uncompensated: pH and one other value (either PaCO2 or HCO3) are abnormal. Abnormal pH determines whether acidosis or alkalosis. Abnormal PaCO2 or HCO3 determines whether respiratory or metabolic. PaCO2 abnormal = respiratory; HCO3 abnormal = metabolic. Partial compensation: all values are abnormal. Two values agree (pH and either PaCO2 or HCO3 are BOTH acid or BOTH base), and the remaining value (either PaCO2 or HCO3) is the OPPOSITE of the pH. The value (PaCO2 or HCO3) that agrees with the pH is correct (determines whether respiratory or metabolic). Compensation: pH is normal, both PaCO2 and HCO3 are abnormal. One will be acidotic, the other base. The value that most closely matches the pH identifies the true (underlying) state. If the fully compensated pH is between 7.35-7.40, then the normal pH is closer to the acid end and the acidotic value (either PaCO2 or HCO3) is correct. If the pH is between 7.40-7.45, then the normal pH is closer to the alkalotic end and the base value (either PaCO2 or HCO3) is correct.

Acid-Base Interpretation
Respiratory acidosis uncompensated

Table Values
pH PaCO2 HCO3 Aci d X X Aci d X X Aci d pH PaCO2 HCO3 X Aci d pH PaCO2 HCO3 Normal X Base X X Aci d pH PaCO2 HCO3 X Normal Base X X X Aci d Normal X X X Aci d X X Aci d X X Aci d Normal Base Base Normal Base X Normal

Respiratory acidosis partially compensated

pH PaCO2 HCO3

Base

Respiratory acidosis totally compensated Respiratory alkalosis uncompensated Respiratory alkalosis partially compensated Respiratory alkalosis totally compensated
pH PaCO2 HCO3

Normal X

X Base

Metabolic acidosis uncompensated

pH PaCO2 HCO3

X Normal Base

Metabolic acidosis partially compensated

pH PaCO2 HCO3

X Normal X X X Aci d Normal Base X X Aci d Normal X Base X X Aci d Normal X X X X Base Base

Metabolic acidosis totally compensated

pH PaCO2 HCO3

Metabolic alkalosis uncompensated

pH PaCO2 HCO3

Metabolic alkalosis partially compensated

pH PaCO2 HCO3

Metabolic alkalosis totally compensated

pH PaCO2 HCO3