Mixed Respiratory And Metabolic Acidosis Abg

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Acid-base Disorders - Endocrine And Metabolic Disorders - Merck Manuals Professional Edition

(Video) Overview of Acid-Base Maps and Compensatory Mechanisms By James L. Lewis, III, MD, Attending Physician, Brookwood Baptist Health and Saint Vincents Ascension Health, Birmingham Acid-base disorders are pathologic changes in carbon dioxide partial pressure (Pco2) or serum bicarbonate (HCO3) that typically produce abnormal arterial pH values. Acidosis refers to physiologic processes that cause acid accumulation or alkali loss. Alkalosis refers to physiologic processes that cause alkali accumulation or acid loss. Actual changes in pH depend on the degree of physiologic compensation and whether multiple processes are present. Primary acid-base disturbances are defined as metabolic or respiratory based on clinical context and whether the primary change in pH is due to an alteration in serum HCO3 or in Pco2. Metabolic acidosis is serum HCO3< 24 mEq/L. Causes are Metabolic alkalosis is serum HCO3> 24 mEq/L. Causes are Respiratory acidosis is Pco2> 40 mm Hg (hypercapnia). Cause is Decrease in minute ventilation (hypoventilation) Respiratory alkalosis is Pco2< 40 mm Hg (hypocapnia). Cause is Increase in minute ventilation (hyperventilation) Compensatory mechanisms begin to correct t Continue reading >>

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A lecture on the physiology of normal acid-base regulation, including a discussion of the bicarbonate buffering system, the Henderson-Hasselbalch equation, and elimination of acid from the body via the lungs and kidneys. Use of the VA and Stanford name/logos is only to indicate my academic affiliation, and neither implies endorsement nor ownership of the included material.

Acid-base Tutorial - Interpretation

by "Grog" (Alan W. Grogono), Professor Emeritus, Tulane University Department of Anesthesiology What is a moderate interpretation of the text? Halfway between what it really means and what you would like it to mean? - Antonin Scalia. This page describes the interpretation of the acid-base component of blood gas results. Designing the interactive acid-base diagram necessitated the development of a logical approach. This page converts the logic back into a human process. Constraints of Not Knowing Patient Details: In a Perfect World complete information about a patient is available before acid-base values are analyzed. What follows is a logical framework for looking at acid-base values with no patient. Reports may say that the results are "typical of" or "characteristic of" a single clinical problem. However, identical results can also be obtained from a complex combination of clinical problems. Step 1: Is the pH normal, acid, or alkaline critical because it governs all the subsequent thinking. In acute problems the change is usually acidic - a low pH - e.g., 7.2 or 7.1. This is because failure, either respiratory or metabolic, results in the accumulation of acids. The following par Continue reading >>

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  1. James Pearson

    We get few actual fake calls, most are at least made with good intentions, even if they don’t really require an ambulance. When it comes to a fake call, drunk-abetics can be annoying.
    A drunk driver gets pulled over by the cops, he staggers out of his car, fails a field sobriety test, then tells the officer, “I’m not drunk, I’m diabetic, and my sugar is too high, I was going home to get my insulin”. The symptoms of hyperglycemia are similar to being drunk, including ketoacidosis, which causes a smell similar to alcohol on a person’s breath.
    So, we get dragged out of bed at 0200 (if we’re lucky enough to be in bed) to check a person’s blood sugar with a glucometer, and tell the cops that whatever is going on with their prisoner, it isn’t related to blood glucose levels.
    Another similar call is the stainless steel induced myocardial infarction (SSIMI). That’s when the application of handcuffs causes the patient to experience rapid onset chest pain and shortness of breath, which they are sure is an impending heart attack, meaning they should bypass the jail and go to the ER.
    Given a choice of ER or jail, the patient will usually beat the EMTs into the ambulance. Some of them, knowing that they will go to jail as soon as the ER clears them will decide to just go with the cops and get it over with. A very few actually end up admitted to the hospital for a genuine medical problem.

    Let me also add: This isn’t meant as any slam against diabetics, only those pretenders trying to avoid consequences. If someone is diabetic, and appears drunk, it’s a serious medical emergency. Do not assume anything, get help.

  2. David Wayne

    Chest pains from an “arguement”. Usually the patient is young (20s) with no medical history, they just want to get away from the arguement. Which I understand getting away to let things cool down, but an ambulance ride to the hospital is a bit much.

  3. Scarlett DéLìon

    This isn’t actually a fake call so much as one of the weirdest calls I have ever gone on. Recently we had been paged for a female patient with abdominal pain, she was also in that age range where there was a possibility of pregnancy.
    We get to the house and I walk in, announce “Ambulance.” and….. nothing…. no reply, no moaning, no groaning, nothing. I start to search the house, going to the living room from the kitchen (came in through the garage) and no one in the living room…. strange… but then again could be in the bedroom. Knock on the first bedroom door and nothing. No one. Still no sound. Go to the next room and same thing. Eventually me and my trainee have checked all rooms in the place and theres literally no one there but us.
    At this point I’m concerned, we get in contact with dispatch and they say that there was no vehicle at the location; which is why the patient called 911.

    Eventually we give up the search and return to station. I check facebook and look up the person that called. It’s a legit person, but they’ve been posting for the past hour or two, I never messaged them but it was somewhat annoying that they never even tried to make contact with 911 again after saying “hey I got a ride” or something.

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(Visit: http://www.uctv.tv/) Eve Van Cauter, Professor of Medicine at the University of Chicago, directs the the Sleep, Metabolism and Health Center. She explores how sleep loss and poor sleep quality are risk factors for obesity and diabetes. Series: "UCSF Center for Obesity Assessment, Study and Treatment" [12/2012] [Health and Medicine] [Show ID: 24581]

Types Of Disturbances

The different types of acid-base disturbances are differentiated based on: Origin: Respiratory or metabolic Primary or secondary (compensatory) Uncomplicated or mixed: A simple or uncomplicated disturbance is a single or primary acid-base disturbance with or without compensation. A mixed disturbance is more than one primary disturbance (not a primary with an expected compensatory response). Acid-base disturbances have profound effects on the body. Acidemia results in arrythmias, decreased cardiac output, depression, and bone demineralization. Alkalemia results in tetany and convulsions, weakness, polydipsia and polyuria. Thus, the body will immediately respond to changes in pH or H+, which must be kept within strict defined limits. As soon as there is a metabolic or respiratory acid-base disturbance, body buffers immediately soak up the proton (in acidosis) or release protons (alkalosis) to offset the changes in H+ (i.e. the body compensates for the changes in H+). This is very effective so minimal changes in pH occur if the body is keeping up or the acid-base abnormality is mild. However, once buffers are overwhelmed, the pH will change and kick in stronger responses. Remember tha Continue reading >>

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    http://care.diabetesjournals.org/conten … 5.full.pdf

    From the Department of Medicine, King Faisal Specialist
    Hospital and Research Center, Jeddah, Saudi
    Address correspondence to Dr. T.A. Elhadd, MD,
    Department of Medicine, King Faisal Specialist Hospital
    and Research Center, Jeddah 21499, Saudi
    Arabia. E-mail: tarikelhadd58[at]gmail.com.
    © 2006 by the American Diabetes Association.
    Try this, I did.
    https://www.google.co.id/search?num=100 … 301dU_ixv4

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