A 40yr male patient presents with OOHCA. During arrest he received thrombolysis for potential STEMI and 10mmol KCL to treat an initial VBG K 2.5
The team then achieved ROSC and the following ABG was obtained immediately after placement of arterial line.
Please outline you management?
80 year old man presented with shortness of breath. This patient had history of CHF and COPD. His venous blood gases showed the following
PH = 7.39, that is within the normal range.
pCO2 = 30 mmHg, that is slightly low. This patient might have respiratory alkalosis.
Next, we should look at the compensation for respiratory acidosis. (This patient is 2 years old. The condition will be acute).
2-year-old boy brought to ED by ambulance as category 1 for severe croup. His blood gases showed the following.
PH = 7.39
PH = 6.782, that is severe acidaemia.
HCO3 = 2.5 mmol/L, that is extremely low. So we have metabolic acidosis.
Next we need to calculate the compensation and find out what type of metabolic acidosis this patient has.
72 year-year-old man with history of type II DM and has a single kidney. Presented with 2 weeks of diarrhoea. He has been in bed for 2 weeks. Unresponsive. Last proper meal was 2 weeks ago. His Venous blood gases showed the following:
PH = 6.782
pCO2 = 17 mmHg
pO2 = 75 mmHg
Question 1:
PH = 7.30, that is mild acidaemia.
HCO3 = 18, that is low (less than 24), So we have metabolic acidosis.
Once we have metabolic acidosis, next step is to calculate compensation and anion gap.
17-year-old boy with wrist fracture. This patient became blue during manipulation of the fracture under bier’s block anaesthetic effect.
Arterial blood gas was performed and it showed the following:
PH = 7.30
PCO2 = 28 mmHg
This VBG was from a young girl with sever gastroenteritis (Vomiting and diarrhoea) for 3 days.
PH = 7.52, that is moderate alkalaemia.
pCO2 = 21 mmHg. So, we have respiratory alkalosis.