Performing an ABG and being able to interpret the results is a hugely important skill, especially for the FY1 on call who has been bleeped to review a sick patient on the ward. However, unlike venepuncture and cannulation, it is massively underpractised by the vast majority of medical students approaching finals.
Hints and Tips for the Exam
Practise on Actual Patients
Although you will be provided with a manikin arm in the OSCE, it is wise to practise the ABG on real patients because it is a vital skill for an FY1 to have. The best way to do this is to meet the FY1 on the respiratory or acute medicine firm after the ward round and ask them which patients will be requiring an ABG. Other opportunities may arise if you take time to shadow the on-call medical FY1.
Do Not Forget to Perform Allen’s Test
You risk failing the entire station if you do not perform this simple test, so make sure you always perform it when you practise so that it becomes second nature.
Allen’s test is used to check that both the ulnar and radial arteries are intact. This is important because an ABG can theoretically damage the radial artery and cause haematoma formation that compresses the artery and compromises blood flow. If this were to happen, the ulnar artery would have to be intact to supply blood to the hand and prevent ischaemic tissue damage. Carry out the test as follows:
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