Acid-Base Disorders

First Things First (assess and treat for the following)

  • Always attend to ABCs as first priority.
    • Is airway patent?
    • Can pt maintain his/her current work of breathing (is intubation required)?
    • Is pt hypotensive?
    • Does pt have evidence of hypoperfusion?
    • Does pt have evidence of hypovolemia, hypervolemia or diminished cardiac output?
  • Acid-base disorders commonly occur in response to underresuscitated shock states.
    • Hypotension is a late finding in shock.
    • Assess for other evidence of end-organ hypoperfusion.
  • Complex acid-base disorder calculations should be straightforward if you adopt a consistent stepwise approach (see “General Management Principles” section).

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Last updated: April 12, 2010