Podcast 559: Metabolic Acidosis

Podcast 559: Metabolic Acidosis

Contributor: Dylan Luyten, MD

Educational Pearls

  • Acidosis can be caused by a respiratory, metabolic, or mixed source
  • A respiratory acidosis will have a low serum pH and elevated bicarbonate if it's chronic, but most importantly end tidal CO2 or arterial CO2 will be high.
  • With a metabolic acidosis we expect to see a low serum pH and low serum bicarbonate.
  • Once it's determined a patient is in a metabolic acidosis, we need to determine if it's an elevated anion gap or normal anion gap acidosis. Anion gap is calculated by subtracting the serum anions from the cations, or serum sodium minus the serum chloride and CO2 (Na-(Cl+CO2)). A normal gap is 6-10, gaps over 10 have an elevated anion gap acidosis.
  • The causes of an elevated anion gap acidosis can be remembered with MUDPILES mnemonic (Methanol, Uremia (renal failure), Diabetes/DKA, Paraldehyde, Isoniazid, Lactate, Ethanol/Ethylene glycol, salicylates/aspirin).
  • So when you suspect an elevated gap acidosis you need to evaluate for all causes, so you need to get an venous or arterial blood gas along with lactate, salicylate, and Tylenol levels.

References

  1. Vanmassenhove J. Lameire N. Approach to the patient presenting with metabolic acidosis. Acta Clin Belg. 2019 Feb;74(1):21-27. doi: 10.1080/17843286.2018.1547245. Epub 2018 Nov 24.
  2. Burger MK, Schaller DJ. Physiology, Acidosis, Metabolic. [Updated 2019 Jun 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482146/

Summarized by Jackson Roos, MS3 | Edited by Erik Verzemnieks, MD

Jaksot(1147)

Buprenorphine after Naloxone

Buprenorphine after Naloxone

EMM would like to extend a large thank you to the Pain Management and Addiction Medicine section of the American College of Emergency Physicians for allowing us to post their webinar panel discussion ...

19 Elo 20201h 18min

Podcast 588: Esmolol for Refractory Ventricular Fibrillation

Podcast 588: Esmolol for Refractory Ventricular Fibrillation

Contributor: Ricky Dhaliwal, MD, JD Educational Pearls: Ventricular Fibrillation (VF) is a potentially fatal cardiac arrhythmia; Refractory VF even more so Epinephrine stimulates alpha and beta recep...

18 Elo 20203min

Podcast 587:  Puppies Preventing Burnout?

Podcast 587: Puppies Preventing Burnout?

Contributor: Jared Scott, MD Educational Pearls: Burnout happens. This study reminds us to take a few minutes on shift to take care of yourself. A new study looked at burnout in ER nurses, residents,...

17 Elo 20204min

On the Streets #7: Burns in the Pre-Hospital and ED Setting

On the Streets #7: Burns in the Pre-Hospital and ED Setting

Burns are low-volume, high-acuity injuries that require special attention and care from the pre-hospital team to the Emergency Department and finally to a dedicated burn unit and ICU. As a first respo...

12 Elo 202048min

Podcast 586:  Toxic Shock Syndrome

Podcast 586: Toxic Shock Syndrome

Contributor: Don Stader, MD Educational Pearls: Toxic shock syndrome (TSS) is a rare cause of shock typically caused by Staph aureus or Strep pyogenes, that produces a toxin that leads to rapid onset...

11 Elo 20206min

Podcast 585:  You Sure You Want Colchicine for Gout?

Podcast 585: You Sure You Want Colchicine for Gout?

Contributor: Don Stader, MD Educational Pearls: Gout is an arthritis caused by the deposition of urate crystals into the joint space Colchicine works by disrupting microtubules and prevents white blo...

10 Elo 20203min

Podcast 584:  Ketamine for Depression and Suicidality

Podcast 584: Ketamine for Depression and Suicidality

Contributor: Jared Scott, MD Educational Pearls: Suicide is currently the 10th leading cause of death in the US  Low quality studies have reported ketamine as a potential promising agent in treating ...

4 Elo 20203min

Podcast 583:  Raise Your Hands if You Have Carpal Tunnel Syndrome

Podcast 583: Raise Your Hands if You Have Carpal Tunnel Syndrome

Contributor: Aaron Lessen, MD Educational Pearls: Hand raising test: a simple but effective tool to diagnose carpal tunnel  Patients hold their hands over their head and if symptoms of carpal tunnel ...

3 Elo 20202min

Suosittua kategoriassa Tiede

rss-poliisin-mieli
rss-mita-tulisi-tietaa
tiedekulma-podcast
docemilia
rss-luontopodi-samuel-glassar-tutkii-luonnon-ihmeita
rss-duodecim-lehti
radio-antro
utelias-mieli
filocast-filosofian-perusteet
rss-lapsuuden-rakentajat-podcast
rss-lihavuudesta-podcast
rss-sosiopodi