Pulmonary Diagnostics II

Arterial and capillary blood gas sampling, acid-base and gas exchange, ABG analyzers, and pulmonary imaging (chest x-ray, CT, MRI, ultrasound, V/Q, PET).

Lessons

Arterial & Capillary Blood Gas Sampling

Objective 1.1.1 — ABG indications, contraindications, hazards, and sample sites; equipment selection; Modified Allen test; radial, brachial, and femoral puncture; indwelling arterial lines (A-lines) including dampening and transducer position; and capillary blood gas procedure.

Acid–Base Homeostasis

Objective 1.2.1 — pH and [H⁺] chemistry; pH homeostasis via lungs, kidneys, and blood buffers; CO₂ production, transport, and excretion; energy metabolism and the respiratory quotient (RQ); the oxyhemoglobin dissociation curve and its modifiers (pH, temperature, 2,3-DPG, Bohr/Haldane effects); and step-by-step ABG interpretation using ROME.

Evaluating Oxygenation, Blood Gas Analyzers & QA/QC

Objective 1.3.1 — Hypoxemia vs. hypoxia and PaO₂ staging (with age adjustment); arterial oxygen content (CaO₂); the alveolar air equation and A–a gradient; SANZ/Severinghaus/Clark electrodes; co-oximetry and the four hemoglobin species (HbO₂, HbCO, MetHb, SHb); point-of-care testing (i-STAT); regulatory agencies (CLIA, CAP, TJC, CLIP, CMS, NCCLS); calibration (1-, 2-, 3-point); and Levey-Jennings / Westgard quality-control rules.

Radiographic Imaging & Chest X-ray Interpretation

Objective 1.4.1 — Chest X-ray overview, indications, positions/projections (PA, AP, lateral neck, lateral decubitus), quality evaluation (penetration, rotation, inspiration), anatomical landmarks, and tube/catheter placement verification.

Abnormal Chest X-ray & Advanced Imaging Interpretation

Objective 1.5.1 — Identify abnormal chest X-ray findings across common cardiopulmonary pathologies (COPD, pneumonia, atelectasis, pleural effusion, pneumothorax, hemothorax, left heart failure, PE, ARDS, epiglottitis, croup, foreign body aspiration, flail chest) and describe the clinical utility of advanced imaging modalities (CT, MRI, ultrasound, V/Q scan, PET).

Module Exam

Comprehensive 50-question module exam covering ABG sampling, acid-base homeostasis, oxygenation evaluation, blood gas analyzers, chest X-ray interpretation, advanced pulmonary imaging, and quality control.