The ABG: A Thing We Do For No Reason

Hospital medicine catches up to emergency medicine.

Emergency medicine isn’t always perfect. By virtue of its wide scope, it cannot be deep – and, in a time-compressed, resource-limited environment, perfect is frequently the enemy of the good.

Thus, for many years, the venous blood gas has been relied upon as “good enough”, particularly for the diagnosis of respiratory failure and hypoventilation. This practice is occasionally at odds with admitting services whose practice may have traditionally relied upon arterial blood gases. ABGs, however, are more challenging, time-consuming, and painful to obtain.

So, I am happy to see the Journal of Hospital Medicine featuring the VBG as a recent highlight of a “thing we do for no reason”, and their flow chart is here:

Indications for ABGs are really quite narrow, and rarely within the scope of emergency medicine. Go forth and spread the word!