Venous blood gas

[quickfeet]

Are there any commonly encountered situations where VBG is not an acceptable alternative to ABG?

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[southerndoc]

Are there any commonly encountered situations where VBG is not an acceptable alternative to ABG?

When evaluating pO2. That's about it.

 

[ucbsmd]

When your pulse ox isn't giving a great waveform and you want to know about oxygenation or for p to f ratio to determine if ards (primarily in icu)


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[Tenk]

When your hospitalist won't listen to science and logic...

 

[Siggy]

When your hospitalist won't listen to science and logic...

As an IM resident... because it's a PITA to get at my hospital. The RNs complain that they can't draw gases, the RTs claim they can't do a venous stick and 4 hours later when I don't have a result I say, "Fornicate this," cancel the order and just order an ABG. The patient's radial artery be damned.

 

[TooMuchResearch]

Are there any commonly encountered situations where VBG is not an acceptable alternative to ABG?

In the ED? No.

 

[e30ftw]

As an IM resident... because it's a PITA to get at my hospital. The RNs complain that they can't draw gases, the RTs claim they can't do a venous stick and 4 hours later when I don't have a result I say, "Fornicate this," cancel the order and just order an ABG. The patient's radial artery be damned.

wait, what?

It's a POC/istat test ran from a green top. Anyone who can draw blood can fill a green top, take it to the RT, have them run a VBG. takes 5 minutes.

 

[Druggernaut]

Here's a quick primer for you: VBG versus ABG • LITFL: Life in the Fast Lane Medical Blog

 

[deleted109597]

wait, what?

It's a POC/istat test ran from a green top. Anyone who can draw blood can fill a green top, take it to the RT, have them run a VBG. takes 5 minutes.

Clearly the place where you work has a thing called common sense. It's sorely lacking at my hospital.

 

[deleted547339]

When I was an EM resident, I drank the koolaid. Now as a CCM fellow, I definitely see the utility of ABG over VBG.

A VBG is a great screen in the ED, but if a patient is going to the ICU, an ABG can be helpful. In extremes, the correlation can get worse - particularly in severe shock. An ABG helps establish a P:F ratio to trend. Also, winters formula isn't validated in VBG so you don't necessarily have an appropriate understanding of the acid/base physiology.

I think if you have a good intensivist group and patients go to the ICU quickly, it doesn't matter. It you are boarding patients for a while, am ABG may be helpful.

 

[Siggy]

wait, what?

It's a POC/istat test ran from a green top. Anyone who can draw blood can fill a green top, take it to the RT, have them run a VBG. takes 5 minutes.

1. We don't generally run iSTATs for floor patients.
2. Given the mismatch between the iSTAT lactate and lab lactate and iSTAT chem panel and lab chem panel at my hospital, I don't trust the iSTATs further than I can throw them.

 

[Zebra Hunter]

1. We don't generally run iSTATs for floor patients.
2. Given the mismatch between the iSTAT lactate and lab lactate and iSTAT chem panel and lab chem panel at my hospital, I don't trust the iSTATs further than I can throw them.

You realize ABGs are run on the same machines as VBGs, right?

 

[Siggy]

You realize ABGs are run on the same machines as VBGs, right?

An ABG machine (same brand that my hospital uses. It also runs VBGs):

iSTAT:

The post I was responding to specifically mentions using an iSTAT for running the lab.