during cpr, blood gases are drawn and the results are
FIO2=1.0
pH=7.15
PACO2=55 mmHg
HCO3=12mEq/l
PaO2=210 mmHg
What action would you take to correct the acid base shown here?
A. increase the rate of ventilation
B. Decrease the FIO2
C. Administer sodium bicarbonate intravenously
D. Add positive end-expiratory pressure to the ventilation system
I am guessing the answer would be D but not sure. Can someone please explain what the answer would be and why?
2007-03-26 16:10:40 · 3 answers · asked by Missy 2 in Health ➔ Diseases & Conditions ➔ Respiratory Diseases
Not D. The patient is oxygenating enough so doesn't need PEEP. He is not ventilating, however, with a PACO2 of 55 and acidic Ph. This is a combined respiratory and metabolic acidosis; with the HCO3 also too low; kidneys (buffer system) not compensating for the acidosis. Decreasing FiO2 would not change the PH. BTW, this person is not a CO2 retainer (PCO2 >60 with normal Ph) using hypoxic drive.
I would first increase the rate of ventilation (A) since I'm ambu bagging! Sodium bicarb (C) is often the choice during a code situation.
2007-03-26 17:19:58 · answer #1 · answered by Helen the Hellion 6 · 2⤊ 2⤋
Even though the pco2 is elevated, I wouldn't raise the rate of ventilation, its not that high, the fio2 cannot be decreased during the patient being ambu'd, and the person is oxygenating so peep should not be an option either.
My answer is give bicarb, with a bicarb of 12 it is warrented to administer bicarb.
2007-03-27 06:03:20 · answer #2 · answered by steveangela1 5 · 1⤊ 2⤋
I agree with RT. Not much gas exchanging is going on during a code, so you need to correct your acidosis (which is significant) an give the bicarb. At this point, the other therapy may be done, but first correct acidosis. Turning down o2 isnt' going to work quick enough to correct ph
2007-03-27 09:01:42 · answer #3 · answered by nickname 5 · 0⤊ 1⤋