Clinical Case Database / Category: Practical Procedure
Taking an arterial blood gas
Publication details
Dr Burhan Khan
Foundation Years Journal, volume 5, issue 1, p.53 (123Doc Education, London, February 2011)
Abstract
A 36 year old man, who is a known asthmatic, presents to the Accident and Emergency department with worsening shortness of breath and wheeze. He is tachypneoic, unable to complete sentences and has bilateral polyphonic wheeze on chest auscultation. What single investigation is required to appropriately diagnose and manage this patient?
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Authors
Dr Burhan Khan
Consultant Physician
Respiratory & General Medicine
Darent Valley Hospital
Dartford
Kent
DA2 8DA
burhan.khan@nhs.net
References
1. Mizma D, Janchar T. Arterial puncture and cannulation. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 4th ed. Philadelphia, Pa: Saunders Elsevier 2004: chap 20
2. British guidelines on the management of asthma. British Thoracic Society and Scottish Intercollegiate Guidelines Network. Thorax May 2008; 63 (Suppl IV): iv1-121
3. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, Peterson E, Tomlanovich M. Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock. N Eng J Med 2001. 345:1368-1377
4. Tegtmeyer K, Brady G, Lai S, Hodo R, Braner D. N Engl J Med 2006;354:e13
5. Aaron SD, Vandemheen KL, Naftel SA, Lewis MJ, Rodger MA. Topical tetracaine prior to arterial puncture: a randomized, placebo-controlled clinical trial. Respir Med 2003. 97 (11): 1195–1199
6. DM Sado, CD Deakin. Local anaesthesia for venous cannulation and arterial blood gas sampling: are doctors using it? J R Soc Med 2005; 98: 158-160
7. Mahoney JJ, Harvey JA, Wong RL, Van Kessel AL. Changes in oxygen measurements when whole blood is stored in iced plastic or glass syringes. Clin Chem 1991. 37 (7): 1244–1248
8. Sabin S, Taylor JR, Kaplan AI. Clinical experience using a small-gauge needle for arterial puncture. Chest 1976; 69: 437-438
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Conflict Of Interest
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When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.
About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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