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ABG Analysis - 5 Steps ROME

The document describes the ROME method for analyzing arterial blood gases (ABGs) to determine acid-base status. Applying the method to a sample ABG, the summary is: 1. The pH is below normal at 7.12, indicating acidosis. 2. The elevated PaCO2 of 60 indicates a respiratory cause (acid), and the opposite directions of the pH and PaCO2 arrows show this is a respiratory acidosis. 3. The elevated HCO3 of 29 indicates compensation from the metabolic system (base), but it does not fully compensate the acidosis as the pH remains abnormal at 7.12. Therefore, the conclusion is that the patient has a respiratory acidosis

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924 views2 pages

ABG Analysis - 5 Steps ROME

The document describes the ROME method for analyzing arterial blood gases (ABGs) to determine acid-base status. Applying the method to a sample ABG, the summary is: 1. The pH is below normal at 7.12, indicating acidosis. 2. The elevated PaCO2 of 60 indicates a respiratory cause (acid), and the opposite directions of the pH and PaCO2 arrows show this is a respiratory acidosis. 3. The elevated HCO3 of 29 indicates compensation from the metabolic system (base), but it does not fully compensate the acidosis as the pH remains abnormal at 7.12. Therefore, the conclusion is that the patient has a respiratory acidosis

Uploaded by

Kschlese
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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ABG Analysis: ROME Method

Normal values - pH = 7.35 -7.45, PaCO2 = 35-45, HCO3 = 22-26

Sample ABG:
pH =7.12
PaCo2 = 60
HCO3 = 29

ROME Method (Respiratory Opposite, Metabolic Equal). Label each value with either  or 
arrows.

Step1: Analyze the pH. Normal pH levels are 7.35--‐7.45.


The first step in analyzing ABGs is to look at the pH.
If blood pH falls below 7.35 , it is acidic.
If blood pH rises above 7.45 , it is base-alkalotic.
If it falls into the normal range, label what side of 7.40 it falls on.
Lower than 7.40 is normal/acidic , higher than 7.40 is normal/alkalotic .
 Label it. ph = 7.12  = ACIDOSIS

Step2: Analyze the CO2 (remember CO2 is an acid). Normal PaCO2 levels are 35--‐45mmHg.
The second step is to examine the PaCO2.
Below 35 is base-alkalotic .
Above 45 is acidic .
 Label it. PaCO2 =60  = acid

Step 3: Analyze the HCO3 (remember HCO3 is a base). Normal HCO3 levels are 22--‐26 mEq/L.
The third step is to look at the HCO3 level.
Below 22, is acidotic 
Above 26, is base -alkalotic .
 Label it. HCO3 = 29  = base-alkaline

Step 4: Compare the pH to the CO2 and the pH to the HCO3

Does the pH indicate acidosis or alkalosis?


 ph = 7.12  = ACIDOSIS

Check - did the PaCo2 arrow go in the opposite direction of the pH -see-saw? If so the primary
problem is respiratory.
 Ph = 7.12  = ACIDOSIS
 PaCO2 =60  Arrows did see-saw, therefore the primary problem is RESPIRATORY
ACIDOSIS.
Check -did the HCO3 arrow go in the same direction -follow the pH? If so the primary problem
is metabolic.
 Ph = 7.12  = ACIDOSIS
 HCO3 = 29  The pH and HCO3 arrows did not go in the same direction. The primary
problem is not metabolic acidosis.

Step 5: Determine if there is compensation. Does the CO2 or HCO3 go the opposite direction
of the pH?
Does either the CO2 or HCO3 go in the opposite direction of the pH? If so, there is compensation
by that system.
We do not use arrows for determining compensation. Label the ABG values as either acid or
base.

pH 7.12 = acid
PaCO2 60 = acid
HCO3- 29 base = opposite pH
 The pH is acidotic, the CO2 is acidotic, and the HCO3 is base- alkalotic.
 The HCO3 is base, opposite of the acid pH and would be evidence of compensation from
the metabolic system.

If the pH remains abnormal, the compensation is incomplete or partial.


If the pH is normal then compensation is complete or fully compensated.
 pH = 7.12 -abnormal
 Compensation is partial.

Conclusion: Respiratory acidosis with partial compensation

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