Thursday, March 25, 2010

CONSULT ROUNDS: ACID BASE

What we learned! When you deal with an acid base problem
Keep the three golden rules in mind!

1. Is their consistency of the HCO3 and Ph, so check with the equation ( H & H)
    H+ = 24 PC02/ HCo3.  Once you have confirmed internal consistency, move to next step
2. Is there an Anion Gap? Always check for this even if the main disorder is alkalosis as THERE IS ALWAYS SOMETHING HIDING IN the GAP.
3. Look for compensation

This is a simplistic view but in the big picture will help. we all know there are other equations that come in to play and we need to go ahead and figure out how much compensation and so forth, but the hardest ABG to figure out is a triple acid base one and the above 3 things will make it systematic for you.

2 comments:

  1. nice nick...
    just read a nice review by Madias On Metabolic acidosis at nature review of nephrology..
    are you aware a very high phosphorus can cause high anion gap acidosis..

    ReplyDelete
  2. yes Amar
    Take a look at the post called Clinical Case 4.
    WE talked about this few weeks ago! Its fascinating

    ReplyDelete

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