Acid Base Disorders Worksheet
Step 1: Gather the necessary data (Na+, CI-, HCO3-, PH, pCO2). Preferably, all obtained from the same blood sample.
Step 2: Look at the PH.
If pH >7.4 the patient has a primary alkalosis proceed to Step 3a
If pH < 7.4 the patient has a primary acidosis proceed to Step 3b
Step 3: Look at the pCO2.
3a: If pCO2 is >40 patient's alkalosis is metabolic; If pCO2 is -Y patient's alkalosis is respiratory
3b: If pCO2 is >40 patient's acidosis is respiratory; If pCO2 is <40 patient's acidosis is metabolic
Step 4: Look for disorders revealed by failure of compensation.
Step 5: Check if the patient has a significant anion gap (Na - Cl - HCO3 > 12-18).
Step 6: Calculate the corrected bicarb.
Step 7: Make the diagnoses using the differentials below and knowledge of the patient
Step 8: Fix it!
by Joshua M. Steinberg, MD @joshsteinbergMD
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