Tag: Respiratory
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Blood gas analysis, pt 5: metabolic acidosis and alkalosis
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Base excess (BE) and bicarbonate (HCO3-) represent the metabolic components of the acid base equation. In general, both components will change in the same direction. Decreased HCO3– and BE indicate either a primary metabolic acidosis or a metabolic compensation for a chronic respiratory alkalosis. Elevated HCO3– and BE indicate either a primary metabolic alkalosis or…
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Blood gas analysis, pt 4: respiratory acidosis and alkalosis
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Assessing the respiratory component is simple. A quick glance at the partial pressure of carbon dioxide (PCO2) level can tell you whether a respiratory acidosis or alkalosis is present. If the PCO2 level is elevated (respiratory acidosis) then either a primary respiratory acidosis is present, or it is the result of a compensatory response to…
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Blood gas analysis, pt 3: interpreting pH
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After taking note of the direction of the pH shift – acidaemia or alkalaemia – it is important to determine the primary and secondary causes. If an acidaemia is present (pH less than 7.35), an underlying respiratory or metabolic acidosis, or both, must exist. Similarly, if an alkalaemia is present (pH more than 7.45), an…
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Blood gas analysis, pt 2: acid-base disturbances
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Acid-base disturbances are common in critical patients. These changes must be identified, as even minor deviations from the normal range can lead to significant abnormal body functions. Acidaemia and alkalaemia Acidaemia, which occurs when blood pH falls below 7.35, will lead to: impedance of cardiac output reduced cardiac contractility a blunted response to catecholamine manifesting…
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Blood gas analysis, pt 1: why everyone needs to know about it
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For those of you who have received referral histories from emergency or specialists hospitals, blood gas analysis is probably no stranger to you. For those who have never heard of them before, fear not – you are in for a treat. In my emergency hospital, the blood gas analyser is arguably one of the most…
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Encouraging mums ‘back to what they love’
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A mother of four appointed as the new head of nursing services at one of the UK’s leading animal hospitals is marking International Women’s Day (today, 8 March) by urging more mums to consider returning to work after having children. Kathryn Latimer Jones has taken on the senior role at Linnaeus-owned Northwest Veterinary Specialists (NWVS)…
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Focus on GDV, part 4: the recovery
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Postoperatively, gastric dilatation-volvulus (GDV) patients remain in our intensive care unit for at least two to three days. Monitoring includes standard general physical examination parameters, invasive arterial blood pressures, ECG, urine output via urinary catheter and pain scoring. I repeat PCV/total protein, lactate, blood gas and activated clotting times (ACT) immediately postoperatively and then every…
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Focus on GDV, part 2: releasing the pressure
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Last week we covered IV fluid resuscitation and pain relief. This week we will go into more detail about gastric decompression. Gastric decompression can be achieved in two ways: trocarisation stomach tube (orogastric tube) placement The decision on which method to use depends on many factors – personal preferences, past experiences and clinical protocols, to…
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Emesis: a thing of the past?
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Until I started researching this Tip of The Week, I did not know the medical profession has abandoned the routine use of emesis in oral poisoning. This is based on multiple medical literatures that have proven emesis induction does not influence the clinical severity of poisoning, the length of hospitalisation and the clinical outcome or…
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Isoflurane and oxygen: the dangers of 2 and 2
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It is a common practice to place all patients on 2% isoflurane and 2l/min oxygen flow rate, but blanket isoflurane saturations and oxygen flow rates can be dangerous. Without a doubt, the majority of patients seem to do just fine at these levels; but every patient is different, and simply placing all patients on 2%…