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Pco2 In Dka

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Is A Vbg Just As Good As An Abg?

Faculty Peer Reviewed A rapid response is called overhead. As white-coated residents rush to the patient’s bedside, the medical consult starts to shout out orders to organize the chaos. “What’s the one-liner?” “Whose patient is this?” And of course, “Who’s drawing the labs?” Usually, at this point, the intern proceeds to collect the butterfly needle, assorted colored tubes, and the arterial blood gas (ABG) syringe. If lucky, there’s a strong pulse. The intern pauses, directs the needle, and hopes for that pulsatile jet of bright red blood to come through the clear tubing. If successful, a sigh of relief. If not, a wave of defeat and more butterfly needles are scattered across the bed as multiple residents attempt to get the elusive arterial blood. Obtaining the ABG is considered almost a rite of passage for the medicine intern. However in ill patients with thready pulses, it can be difficult to obtain. Also, getting the ABG is not without its complications. Significant pain, hematoma, aneurysm formation, thrombosis or embolization, and needlestick injuries are all risks [1]. Given these risks, the question is whether we are subjecting our patients to undue pain Continue reading >>

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Popular Questions

  1. soxman

    So when a pt comes in with DKA I know that the pH is low due to the acidic ketone bodies and HCO3- gets low in an attempt to buffer and I can understand how initially the PCO2 is low. BUT for most questions I see, the stem usually refers to stating that the patient is lethargic ...so in that case wont the PCO2 be high due to hypoventilation?

  2. Convalaria

    lethargic is the state of consciousness. patient still can hyperventilate, namely DKA coma is characterized by Kussmaul breathing pattern: rapid and deep

  3. soxman

    Convalaria said: ↑
    lethargic is the state of consciousness. patient still can hyperventilate, namely DKA coma is characterized by Kussmaul breathing pattern: rapid and deep makes sense! thanks!

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