Interpretation of blood gas analysis by physicians in a community teaching hospital

Forty-two interns and residents on the staff of a community teaching hospital were questioned to assess their understanding of blood gas abnormalities. Misunderstandings were such that 24% of the residents and interns might have given inadequate care had their interpretations dictated practice. Few therapeutic misadventures in fact occurred, largely because of supervision. Even without supervision, it is unlikely that much harm would have come about, partly because pattern recognition and rules of thumb provided adequate guidance and partly because no notice was taken of the results of the blood gas analysis anyway. Those who wish to promote rational practice should direct their educational efforts to improved understanding of the mechanisms of hypoxaemia and of the chemical, physiological and pathophysiological interactions of PCO2, bicarbonate and pH in the various acid-base disorders.