Pondering Acid-Base Part 1: Making Sense of the Chaos!

So much pathology is reflected in the acid-base status of a patient. 

I've always found acid-base analysis challenging. I probably look at a couple of VBGs on most of my shifts in the ED, and up until now have scarcely ventured beyond the basics.

I used to be able to say whether a patient was acidotic/alkalotic (or is it acidaemic/alkalaemic??), and I could usually indicate whether the primary aetiology was respiratory or metabolic. On a good day, I may have been able to stumble my way through saying if there was any degree of ‘compensation’ (I think). But beyond that I got lost in a haze of confusion and numbers.

Case 2: She Came Disguised as an Acute Abdomen...

Here is a presentation we put together on this case. We skim over a lot of the content, which is covered in greater detail in the written post. We used prezi.com for the ‘virtual canvas’ style presentation.



   

The situation…

It was a Saturday night in a small suburban ED. It was my first ever night shift as the senior doctor in the ED – I was intensely nervous and experiencing major cognitive overload!