Can anyone point me in the direction of an idiots guide for these two things please. Uni notes are worse than useless.

Any help much appreciated.

ecg made easy is good for ecg’s

http://www.ecglibrary.com/ecghome.html is also useful.

http://www.acid-base.com/ i’ve always found useful for blood gases stuff.

What degree are you studying for? That will depend on how ‘deep’ you need to go.

I would say you can learn the basics of ECGs from ECG made easy, but it’ll take a long time of looking at lots before you get ‘good’ at them.

ABGs – well, I can’t comment on the above link as it does look clear, but I haven’t gone into great detail in it. I find, again, that exposure to lots of them is a good learning tool. Another good resource is the ‘info’ above the ABG machine as that is a good, quick, simple guide…

The thing for ABGs is to remember – it’s not just the O2 level you’re interested in!
I look at it as:
1)pH – high, low, normal…?
2)PaCO2 – is THAT high, low, normal, and is THAT causing the pH abnormality? If so, it’s a respiratory issue.
3)Bicarb/BEx – is THAT high, low, normal, and is THAT causing the pH abnormality..etc etc..
4)Is one COMPENSATING for the other? This usually means a CHRONIC state. If not, it’s usually an ACUTE state.
5)PaO2 – are they hypoxic. Low O2, low CO2 = type 1 failure. Low O2, high/normal CO2 = type 2 failure….

That’s a basic – go online and see if there’s a resource of lots of results that you can interpret Have fun.

DrP

Thank you both very much. Physio degree.

Slight thread hijack….

My Missus had to go into hospital recently and the measured her blood oxygen satruration with a little clip on her finger…. How does it measure it?

End Hijack….

Colour of the blood changes with oxygen saturation, so the clip measures the colour and from that determines the saturation.

SP02 or oxygen saturation works by shining an infra red and a red light through a capillary bed, oxygenated cells block one of those types of light and the other passes through, giving you a percentage. Clever stuff, if only i could remember all the details of the long and boring essay i wrote on the subject a few years back.

no idea about ABG’s really, beyond it hurting a lot, but ECG is a dark art… not sure how much you need to know for physic, but your best bet is getting hold of a paramedic. We see ecg’s all day everyday, and usually when an event is occurring. basic rhythms are Normal sinus, sinus tacky and sinus brady (normal, fast, slow) A lot of older people have atrial fibrillation (no p waves, irregular rate) look out for schema and bundle brach blocks. A.V blocks are straight forward(ish) so you can read up on them.

ST segment elevation is indicative of an MI, depression of angina (its a bit more complex than that, but theres a rough idea) VF is crazy, wide and bizarre, VT is wide but regular, PEA can look however it wants but is regular (without a pulse) asystole is a flat line.

There is loads of books out there, some good, some bad, also loads of web sites.

What DrP said. Also:

pH is low & PaCO2 is high = resp acidosis
pH is high & PaCO2 is low = resp alkalosis
pH is low & HCO3 low = metabolic acidosis
pH is high & HCO3 high = metabolic alkalosis (v. unusual tbh)

Compensation rarely brings the pH bang into the normal range; you can tell if this is happening as the PaCO2 or HCO3 will be the other way round from what you would expect if it was the primary problem, ie. low-normal pH & low PaCO2 probably means resp compensation for a metabolic acidosis, and low-normal pH and high HCO3 probably means metabolic compensation for a resp acidosis.

Respiratory compensation is relatively quick, so a patient with a metabolic acidosis (eg. sepsis) is likely to have an increased minute volume and a low PaCO2; this effect can be seen in diabetic ketoacidosis, for example. Metabolic compensation is much slower, but in someone who has a chronically high PaCO2 (eg. COPD) they will have a high HCO3.

As meehaja said, ABG sampling is painful, which is why God gave us the 20G Vygon Leader Cath.

Hope this is not confusing.

Andy

Edit – If you can get hold of a copy of ECG Made Easy that helped at uni. No substitute for interpreting them every day though