CICM SAQ 2010.2 Q6

CICM_SAQ

Can you interpret these arterial blood gases?

Metabolic mayhem post-subacrachnoid hemorrhage

Life in the Fast lane 150 thumb

An 87 year old female presented with a subarachnoid haemorrhage. GCS 8/15. A nasogastric tube was unable to be placed due to patient agitation. As a consequence, the patient was fasted for five days due to concern about swallowing. Can you figure out her acid-base disturbance?

A Case of CO2 Narcosis

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A 67 year old gentleman with a BMI of 45 was waiting for his respiratory outpatient clinic appointment. While waiting, he fell asleep. A medical emergency was called because he could not be woken up. On arrival of the MET team the patient is found to have a blood pressure of 140/70, a heart rate of 100bpm and oxygen sats of 68% on room air. He is breathing spontaneously but requires airway support. His GCS is 3/15. Supplemental oxygen is applied and the following arterial blood gas is obtained.

HAGMA, LTKR, and CATMUDPILES

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76 year old male living alone. Found obtunded at home by neighbours. Breathing rapidly and muttering incoherently. No other history available. Admission arterial blood gas shown: