Solving Arterial Blood Gas (ABG) Problems Using the ROAM Method

Introduction

• Presenter: Nurse Sarah from RegisteredNurseRN.com
• Topic: Solving ABG problems using the ROAM method
• Alternative Method: Previously covered tic-tac-toe method

ROAM Method Overview

• ROAM Acronym:
  • R: Respiratory
  • O: Opposite
  • M: Metabolic
  • E: Equal
• Concept:
  • Respiratory Opposite (R-O): Focus on PaCO2 and blood pH being opposite
  • Metabolic Equal (M-E): Focus on HCO3 (bicarb) and blood pH being equal

Understanding Lab Values

PaCO2 (Respiratory)

• Normal Range: 35 to 45 mm Hg
• Interpretation:
  • Greater than 45 = Acidic (up arrow)
  • Less than 35 = Basic (down arrow)

HCO3 (Bicarb, Metabolic)

• Normal Range: 22 to 26 mEq/L
• Interpretation:
  • Less than 22 = Acidic (down arrow)
  • Greater than 26 = Basic (up arrow)

Blood pH

• Normal Range: 7.35 to 7.45
• Interpretation:
  • Less than 7.35 = Acidic (down arrow)
  • Greater than 7.45 = Basic (up arrow)

Solving ABG Problems with ROAM

Example Problem 1

• Given:
  • pH: 7.27 (Acidic, down arrow)
  • PaCO2: 42 (Normal)
  • HCO3: 17 (Acidic, down arrow)
• Solution:
  • Metabolic equal
  • Metabolic acidosis (no compensation)

Example Problem 2

• Given:
  • pH: 7.55 (Basic, up arrow)
  • PaCO2: 32 (Basic, down arrow)
  • HCO3: 18 (Acidic, down arrow)
• Solution:
  • Respiratory opposite
  • Respiratory alkalosis (partial compensation)

Example Problem 3

• Given:
  • pH: 7.44 (Normal, basic side)
  • PaCO2: 49 (Acidic, up arrow)
  • HCO3: 33 (Basic, up arrow)
• Solution:
  • Metabolic equal
  • Metabolic alkalosis (full compensation)

Conclusion

• Practice: Use the free quiz available in the video description for more practice problems.
• Resource: Workbook on ABG interpretation available for further learning.