Interpretation of abnormal blood gas results

FRCEM EXAM QuestionsCategory: March 2018Interpretation of abnormal blood gas results
FRCEM Intermediate Staff asked 9 months ago

36 year-old-patient with A.B.G (Ph 7.1) (PaO2 13) (Hco3 14) (PaCo2 7.1 KPa) (Cl 98) (k 4) (Na 134)
A.Interpretation of A.B.G? (1mark)
B.What’s anion gab? Show your calculation? (1mark)
C.What is your management? (1mark)

1 Answers
FRCEM Intermediate Staff answered 9 months ago

A.
Uncompensated-High-Anion Gap Metabolic Acidosis ( is it because of high anion gap?) ( why not Mixed respiratory and metabolic acidosis.

-Uncompensated because Paco2 is high (7.1 kpa)
-High Anion Gap because > 16 (normal range 8-16 mEq/l) and
-Metabolic acidosis because (ph. 7.1, Hco3 14)

B.
(Na+k) – (Hco3+Cl) = (134+4) – (14+98) =26 mEq/l, it’s indicating (High Onion Gap) and primary metabolic problem.

C.
Move the patient to an appropriate area of the department- Call for Help
provide supportive treatment eg fluids, oxygen
Repeat serial ABGs/ ECG – find the cause and treat
consider early intubation and ventilation.