CPD Articles

Mastering blood gas interpretation: A practical guide for primary care providers

Talat Habib, Arun Nair, Shane Murphy, Hamid Saeed, Nyitiba Ishaya
South African Family Practice | Vol 67, No 1 : Part 2| a6058 | DOI: https://doi.org/10.4102/safp.v67i1.6058 | © 2025 Talat Habib, Arun Nair, Shane Murphy, Hamid Saeed, Nyitiba Ishaya | This work is licensed under CC Attribution 4.0
Submitted: 13 October 2024 | Published: 23 April 2025

About the author(s)

Talat Habib, Department of Family Medicine, Robert Mangaliso Sobukwe Hospital, Kimberley, South Africa; and, Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
Arun Nair, Department of Family Medicine, Robert Mangaliso Sobukwe Hospital, Kimberley, South Africa; and, Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
Shane Murphy, Abbey House Medical Centre, Navan, Ireland
Hamid Saeed, Department of Family Medicine, Robert Mangaliso Sobukwe Hospital, Kimberley, South Africa; and, Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
Nyitiba Ishaya, Department of Family Medicine, Robert Mangaliso Sobukwe Hospital, Kimberley, South Africa; and, Department of Family Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

Abstract

Accurate arterial blood gas (ABG) interpretation is essential for primary care providers (PCPs), especially in emergency and inpatient settings where timely, informed decisions can significantly impact patient outcomes. This review guides PCPs from basic to advanced interpretation through a systematic five-step approach for ABG analysis, focussing on oxygenation, pH status, and metabolic and respiratory disorders. Emphasising the recognition of complex acid-base disorders that may coexist even when pH appears normal, it incorporates tools such as delta and osmolar gap calculations to address multiple concurrent metabolic disturbances and clarify the interpretation of mixed acid-base conditions. The article also briefly considers the use of arterial and venous blood samples in clinical practice.

Keywords

blood gas interpretation; primary care providers; simple acid-base disorders; mixed acid-base disorders; five-step approach; anion gap; delta gap.

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