Lab Case 58

A 28 year old obese female presents to your ED with shortness of breath. She is a known asthmatic with three previous hospital admissions for her asthma.

She complains of a sore throat and is currently on a course of amoxicillin from her GP.

Her Vitals signs:

RR 30/min

T 37.4 Celsius

PR 120/min

A venous gas shows:

pH   7.522

CO2  25  (35-45 mmHg)

HCO3   20.5  (22+/- 2 mmol/l

BE   -1.7

Hb   133

Na  146  (137-145 mmol/l)

K  3.6  (3.5-5 mmol/l)

Cl   90  (99-111 mmol/l)

Glucose   5.6  (4-6 mmol/l)

Lactate  3.1   (<2)

Questions:

1. Describe the abnormalities

2. Interpret your finding

3. What are the poor prognostics features for acute asthma?

4. What factors would affect your disposition decision?

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