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

Avsnitt(1146)

Podcast 723: Nitro Drip in Flash Pulmonary Edema

Podcast 723: Nitro Drip in Flash Pulmonary Edema

Contributor: Alec Coston, MD Educational Pearls: Flash pulmonary edema or Sympathetic Crash Acute Pulmonary Edema (SCAPE) is a severe illness that requires aggressive treatment Often in patients with...

25 Okt 20215min

On the Streets #12: Salient Pre-hospital Considerations for Neurosurgical Emergencies - a Smorgasbord Part II

On the Streets #12: Salient Pre-hospital Considerations for Neurosurgical Emergencies - a Smorgasbord Part II

In this podcast, we are back again with host, Jordan Ourada, and neurosurgeon, Dr. Eddie Tsvankin as they discuss an exciting and mind-blowing array of topics pertaining to neurosurgery. Listen as Dr....

20 Okt 202147min

Podcast 722: Lower Extremity Dislocations

Podcast 722: Lower Extremity Dislocations

Contributor: Donald Stader, MD Educational Pearls: Hip Dislocation Prolonged dislocations can impair blood supply to femoral head Hip dislocation for >6 hours puts patient at high risk for needing ...

19 Okt 20216min

Podcast 721: Blakemore & Minnesota Tubes: Part II

Podcast 721: Blakemore & Minnesota Tubes: Part II

Contributor: Dylan Luyten, MD Educational Pearls: To place a Blakemore/Minnesota Tube: Insert into esophagus under visualization Inflate gastric port with 60 cc of air and obtain a chest xray to en...

18 Okt 20217min

On the Streets #11: Salient Pre-hospital Considerations for Neurosurgical Emergencies - a Smorgasbord

On the Streets #11: Salient Pre-hospital Considerations for Neurosurgical Emergencies - a Smorgasbord

On this episode of On The Streets, host, Jordan Ourada sits down with neurosurgeon/neurooncologist Dr. Eddie Tsvankin to discuss various topics concerning neurosurgery and how EMS workers in the field...

13 Okt 20211h 4min

Podcast 720: Blakemore & Minnesota Tubes: Part I

Podcast 720: Blakemore & Minnesota Tubes: Part I

Contributor: Dylan Luyten, MD Educational Pearls: Minnesota Tube has an extra port for suctioning otherwise is the same as a Blakemore Tube Indicated in MASSIVE upper GI bleeding often due to esophag...

12 Okt 20215min

Podcast 719: Normal Saline vs. Tap Water for Wound Irrigation

Podcast 719: Normal Saline vs. Tap Water for Wound Irrigation

Contributor: Ricky Dhaliwal, MD Educational Pearls: Multiple RCTs and a Cochrane Review found there is no difference in wound infection rates when irrigating with tap water  Pressure of the water and...

11 Okt 20213min

Podcast 718: Renal Failure Follow Up

Podcast 718: Renal Failure Follow Up

Contributor: Aaron Lessen, MD Educational Pearls: Patients with acute renal failure often need medical management for hyperkalemia Those with severe electrolyte derangements or absent renal function ...

5 Okt 20213min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
rss-ufo-bortom-rimligt-tvivel
sexet
rss-vetenskapsradion
pojkmottagningen
rss-vetenskapsradion-2
dumforklarat
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
halsorevolutionen
rss-spraket
bildningspodden
hacka-livet
rss-experimentet
medicinvetarna
rss-lara-fran-larda-en-fackbok-och-en-forfattare