ABGs look different here...

So as some of you know, in my free time in the evenings here I have been studying for the NCLEX (nursing board exam). One of the things I was recently reviewing was the normal ranges for arterial blood gases (ABGs). An ABG is a is blood test performed using blood from an artery -- usually the radial artery on the wrist, but sometimes the femoral artery in the groin is used. The test determines the pH, the partial pressure of carbon dioxide and oxygen and the bicarbonate level of the blood. ABGs are primarily used to determine how well gases are being exchanged in the lungs.

Today in the hospital I had the opportunity to put my studying to the test! I was working alongside a wonderful team of nurses in the unidad de cuidado intensivo (Pediatric ICU) in one of the main pediatric hospitals in La Paz, Hospital del Nino (see picture above). After drawing an ABG from a 2 month old baby admitted with respiratory distress, I was shocked when the doctor said the partial pressure O2 reading (Pa02) was ok when it read 58% because I had memorized that the Pa02 reading should ideally be between 80-100%! However, through my broken spanish with the doctor, I quickly learned that the normals here are quite different. 80-100% is applicable for New York City where the altitude is barely 1 meter. However, here in La Paz at an altitude of 3600 meters, the normals are adjusted given the decrease in o2 level in the air. This chart I found online helped to clarify for me...