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Real Doctors (Life Makers)  |  Clinical  |  Medicine & medical subspecialities  |  Acid base balance (1) « previous next »
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dr_b.e.s.m
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Acid base balance (1)
« on: /September/ 28, 2005, 05:15:21 PM »

What is her acid base status?
First start with reading the clinical scenario and try to guess what are the possible acid base conditions . THEN read the arterial blood gases levels.

This is a useful simple guide to Acid Base balance interpretation. http://www.nda.ox.ac.uk/wfsa/html/u13/u1312f11.htm

Quote
An 80 year old lady (wt 40 kgs) was admitted to the Intensive Care Unit following a motor vehicle accident.

She was the driver and was wearing a seat-belt. She had run off the road in her car and hit a tree. She remembered the accident and was not knocked out. Injuries were a left anterior flail segment, a fractured left patella and facial bruising. She was haemodynamically stable but had respiratory distress with paradoxical movement of her left anterior chest wall. There was no head or neck injury. Recently she had had several unexplained blackouts. Only significant past history was of hypertension for which she took propranolol 120 mgs/day.

She was intubated and ventilated in the Casualty department because of respiratory distress. Initial ventilation was tidal volume 1000mls at a rate of 10 breaths/min with 100% oxygen. Arterial gases obtained half an hour later. Peripheral perfusion was good. An intravenous infusion was commenced.

Previous health was good apart from recent 'blackouts'. She was on no regular medication.

Arterial Blood Gases

pH 7.56

pCO2 23 mmHg

pO2 508 mmHg

HCO3 21 mmol/l


For detailed explanation of this case : http://www.anaesthesiamcq.com/AcidBaseBook/AB9_6Case5.php
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