Scenario
A 59 year old obese man receives 5 mg of intravenous morphine for analgesia for abdominal pain. Thirty minutes later, his GCS has fallen to 12 and investigations are performed.
Question
Describe and interpret his Investigations (100%)
Answer
FACEM VAQ Exam 2009.2 – Question 3
- The overall pass rate for this question was 38/67 (56.7%).
- Pass criteria:
- Mixed acid base disturbance with acute respiratory acidosis and underlying metabolic alkalosis
- Or alternatively chronic respiratory acidosis considered acceptable if supporting corrective calculations performed to justify this view despite being discrepant with scenario
- Critical hypoxemia
- Listing most of the eight primary abnormalities present with interpretation of a reasonable number of these.
- Fail criteria: Features in answers that were unsuccessful included:
- Misdiagnosing metabolic acidosis or respiratory alkalosis
- Missing hypoxaemia
- Failure to list the primary abnormalities
- Failure to undertake any corrective calculations for pH, HCO3 or PaCO2
ACEM Fellowship Visual Aid Questions
About Mike Cadogan
