Acid-Base Emergencies

Question 1

VBG are different from ABG, how?

Answer 1

pH is 0.05 less
HCO3 measured
pCO2 directly measureable
Less painful

Question 2

VBG variances

Answer 2

pH  0.05 less
pCO2 6 more
HCO3 same
PaO2 40 less
SaO2 35% less

Question 3

Significance of 12/8/0.1

Answer 3

pH changes 0.1 for every PaCO2 = 12 and HCO3 = 9

Question 4

Are acute abnormalities compensated?

Answer 4

No, not even partially

Question 5

When does compensation occur?

Answer 5

When the pH is near normal in respiratory acidosis

Question 6

Explain double disorder?

Answer 6

When a patient has two disorders that allow the pH to be near normal such as a patient with metabolic acidosis and respiratory alkalosis

Question 7

Anion gap calculation?

Answer 7

= Na - (Cl + HCO3)

Question 8

Elevated anion gap mnemonic

Answer 8

MUD PILES

• Methanol
• Uremia
• DKA
• Paracetamol, Propylene glycol, paraldehyde
• Infection, iron, inborn errors
• Lactic acid
• Ethylene glycol
• Salicylates

Question 9

Where is bicarb measured?

Answer 9

Electrolyte panel

Question 10

When correcting blood gas abnormalities, what do you aim to fix?

Answer 10

The primary cause

Question 11

Blood pH =

Answer 11

-emia

Question 12

Blood states =

Answer 12

-osis

Question 13

pH = 7.35
pCO2 = 64
HCO3 = 32
SaO2 = 88%

Answer 13

Patient is acidemic secondary to respiratory acidosis with complete metabolic compensation and associated hypoxia