Critical care

Question 1

One instance where VBG and ABG do not correlate?

Answer 1

Hypotension

Otherwise correlate well with hypo/hyperthermia and prolonged cap refill

Question 2

Mechanism of shock in spinal cord injury?

Answer 2

Disruption of autonomic pathways below T6 leading to peripheral vasodilation and inhibition of compensatory tachycardic response

Question 3

Mechanism of injury with exposure to:

1) Alkali
2) Acid

Answer 3

1) Liquefaction necrosis

2) Protein coagulation

Question 4

Next step in child w/suspected caustic ingestion:

Answer 4

Urgent referral to GI for possible endoscopy.

Do NOT give charcoal (blocks visualization), or ipecac / gastric lavage -> aspiration / perforation risk