21-year-old man brought for ED for impaired mental state, he was extremely agitated and needed 6 staff members to restrain him for IV access and sedation. His venous blood gases showed the following:
PH = 6.9
pCO2 = 24 mmHg
21-year-old man brought for ED for impaired mental state, he was extremely agitated and needed 6 staff members to restrain him for IV access and sedation. His venous blood gases showed the following:
PH = 6.9
pCO2 = 24 mmHg
Question 1:
PH = 7.43 that is with in normal range, more toward alkalotic spectrum
HCO3 = 39.9, that is elevated so we have metabolic alkalosis. Next we need to check the compensation process.
38 year old lady presented to the emergency department with recurrent vomiting. She was found to have a slipped lapband. Her venous blood gases showed the following
PH = 7.43
pCO2 = 61 mmHg
Question 1:
PH = 7.14, that is severe acidaemia
pCO2 = 53 mmHg, So we have respiratory acidosis. Next we will calculate the compensation.
75 year old man was brought to ED by ambulance in VF cardiac arrest , CPR in progress. His venous blood gases showed the following
PH = 7.14
pCO2 = 53 mmHg
Question 1:
PH = 7.32 ( less than 7.35) so, we have mild acidaemia.
PCO2 = 48 (on arterial blood gas > 40), so we have respiratory acidosis.
32-year-old man presented to ED with an asthma attack. on 3L O2, his arterial blood gases showed the following:
PH = 7.32
Question 1:
PH = 7.30 that is mild acidaemia.
HCO3 = 16 mmol/L (>24) so we have metabolic acidosis.
Next, we need to calculate the anion gap and the compensation (using Winter’s formula)
61-year-old man presented to ED with hypoglycemia that was difficult to correct with oral and IV dextrose. His venous blood gases showed the following.
PH = 7.30
PCO2 = 33 mmol/L
Question 1:
PH = 7.29 That is moderate acidaemia
PCO2 = 60 mmHg, that is high (>40). So, we have respiratory acidosis.
Next, we need to look at HCO3 to determine if it is acute or chronic respiratory acidosis.