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Doing ABG Interpretation Easily by ROME Method

Doing ABGs Interpretation Easily by ROME Method

Arterial Blood Gas Analysis Interepretation is the one of the important skill for physicians, nurses, respiratory therapists, and other health care personnel. ABG interpretation  done to sepcially to critically ill patients in Intensive Care Unit or High Care Unit Patients .  ABG Interpretation Easily by ROME Method

ABG is use to determine the condition of the ill patient especially respiratory or metabolic acidosis/alkalosis

There are many methods for the  interpretation of the ABG .Some of the methods are Tic Tac Toe Method, Stewart’s strong ion difference, ROME Method. and so on. Here we present the ROME Method to Arterial Blood Gases (ABGs) . The ROME method is a simple and quick way to interpretation for the ABG of the blood .


Before interpreting it, we should know the following Normal parameter Value of the ABG reading.

Normal Values in ABG :

  • pH: 7.35 – 7.45.
  • pO2: 10 – 14kPa*
  • pCO2: 4.5 – 6kPa*
  • Base excess (BE): -2 – 2 mmol/l.
  • HCO3: 22 – 26 mmol/l.

The major parameter we have to focus are  pH, CO2, and HCO3 level. They are very important forABGs analysis

  • CO2 level (carbon dioxide) a–> represents the RESPIRATORY system.
  • HCO3 level (bicarbonate) always represents the METABOLIC system.
  • pH within normal level  which is 7.35-7.45
    • if the pH<7.35 –>  acidic blood pH,
    • If the pH > 7.45 is considered an alkalotic blood pH.

    So ,depending upon these valuse we can read as Respiratory acidosis / alkalosis  or Metabolic acidosis /alkalosis. 

ROME stands for

  • Respiratory
  • Opposite
  • Metabolic
  • Equal

When applying the method for ABG interpretation, remember to keep the R and O together and the M and E together

RO is Respiratory Opposite while ME is Metabolic Equal .

  1. RO is Respiratory Opposite

IF CO2and pH will be OPPOSITE –> one will be elevated while the other will be decreased…this means it’s a respiratory disorder. and acidosis or alkalosis depending upon the pH value as below 

  • CO2 ⬆, pH ⬇: Respiratory acidosis
  • CO2 ⬇, pH ⬆: Respiratory alkalosis

2. ME is Metabolic Equal .

The HCO3  and pH will be EQUAL…either both will be elevated or decreased….this means it’s a metabolic disorder.

  • HCO3 ⬇, pH ⬇: Metabolic acidosis
  • HCO3 ⬆, pH ⬆: Metabolic alkalosis

Before solving ABG problems, you must

Blood pH:

  • Normal: 7.35-7.45
  • Acidosis: <7.35
  • Alkalosis: >7.45

CO2 (carbon dioxide):

  • Normal: 35-45 mmHg
  • Acidosis: >45 mmHg
  • Alkalosis: <35 mmHg

HCO3 (bicarbonate):

  • Normal: 22-26 mEq/L
  • Acidosis: <22 mEq/L
  • Alkalosis: >26 mEq/L

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