80 year old lady with type 2 DM was referred for high blood sugar. Her blood gases showed the following:
PH = 7.39
pCO2 = 48 mmol/L
80 year old lady with type 2 DM was referred for high blood sugar. Her blood gases showed the following:
PH = 7.39
pCO2 = 48 mmol/L
Answers:
PH = 7.34, that is very mild acidaemia.
HCO3 = 14 mmol/L. So, we have metabolic acidosis.
Next we need to calculate Anion Gap and compensation.
A police recruit doing a 20 km pack hike. Collapsed. GCS on arrival was 7. His temperature was 39.2 on arrival. His venous blood gases showed the following:
PH = 7.34
pCO2 = 27 mmHg
Answers:
PH = 7.391, that is within the normal range, slightly to the acidic side.
pCO2 = 57 mmHg, that is high. So we have respiratory acidosis.
It is not clear from the history if the condition is acute or chronic. Accordingly we are going to check for both.
71 y old male is coming with palpitations, haemodynamically stable.
This ECG represents fever induced Brugada syndrome.
Needs aggressive treatment of the fever and Cardiology referral for ICD.
Additional information from LITFL:
Brugada Syndrome Key Points
58-year-old lady with history of obstructive sleep apnoea presented with Syncope. Her venous blood gases showed the following:
PH = 7.391
pCO2 = 57 mmHg
Answers
PH = 7.507, that is alkalaemia
pCO2 = 28 mmHg. So, we have respiratory alkalosis.
51 year-old-man with 3 days history of fevers, productive cough, malaise, chest pain and a syncopal episode. His ECG is:
This ECG is typical posterior MI with deep horizontal STD in V1-V3. Patient was transferred to SCGH cathlab priority 1, loaded with Aspirin 300 mg and Heparin 5000 U iv as per their cardiology advice.