Blood gases; Roadside to Resus
11/15/23 • 55 min
Blood gases are really commonly used in ED, Critical Care, Respiratory Medicine and Prehospitally. In fact, you’d do well to walk 10 meters in an ED without being given one to sign off! But it’s for good reason, because they give you additional information about what’s going on from a respiratory and metabolic perspective in the patient.
And it’s probably worth mentioning at this point, this episode is going to be pretty ‘science-heavy’, there should be something in here for everyone; from the clinician that's been looking at these things for the last 30 years, to those that haven't started interpreting gases.
So arterial blood gases can tell you about the efficacy of the patients ventilation in terms of their partial pressures of oxygen and carbon dioxide levels and also from a metabolic perspective about other disorders of their acid-base balance.
In the episode we'll be covering the following;
-Overview of blood gases
-Respiratory & metabolic sides of the gas
-Acidaemia
-Alkalaemia
-Bicarbonate or base excess?
-Compensation
-Oxygenation
-Anion gaps
-System of interpretation
-Venous gases
-Clinical application & examples of interpretation
We'll be referring to the equation listed on our webpage, so make sure you go and have a look at that and all the references listed.
Once you've listened to the podcast make sure you run through the quiz below to consolidate the concepts covered with some more gas examples and of course get you free CPD certificate for your TheResusRoom portfolio!
Once again we'd love to hear any comments or questions either via the website or social media.
Enjoy!
Simon, Rob & James
Blood gases are really commonly used in ED, Critical Care, Respiratory Medicine and Prehospitally. In fact, you’d do well to walk 10 meters in an ED without being given one to sign off! But it’s for good reason, because they give you additional information about what’s going on from a respiratory and metabolic perspective in the patient.
And it’s probably worth mentioning at this point, this episode is going to be pretty ‘science-heavy’, there should be something in here for everyone; from the clinician that's been looking at these things for the last 30 years, to those that haven't started interpreting gases.
So arterial blood gases can tell you about the efficacy of the patients ventilation in terms of their partial pressures of oxygen and carbon dioxide levels and also from a metabolic perspective about other disorders of their acid-base balance.
In the episode we'll be covering the following;
-Overview of blood gases
-Respiratory & metabolic sides of the gas
-Acidaemia
-Alkalaemia
-Bicarbonate or base excess?
-Compensation
-Oxygenation
-Anion gaps
-System of interpretation
-Venous gases
-Clinical application & examples of interpretation
We'll be referring to the equation listed on our webpage, so make sure you go and have a look at that and all the references listed.
Once you've listened to the podcast make sure you run through the quiz below to consolidate the concepts covered with some more gas examples and of course get you free CPD certificate for your TheResusRoom portfolio!
Once again we'd love to hear any comments or questions either via the website or social media.
Enjoy!
Simon, Rob & James
Previous Episode
November 2023; papers of the month
Well this has been a huge month for Emergency Medicine and Critical Care in terms of papers!
We start off looking at REBOA; many resuscitationist's favourite concept or device with the much awaited UK-REBOA trial. What does the paper mean for practice in our Resus Rooms? Is this about to become a key part of trauma management? The paper is fascinating and one of the most though provoking we've discussed in a while.
Next up we look at CROYSTAT-2, another such anticipated trial looking at whether survival could be improved by administering an early and empirical high dose of cryoprecipitate to all patients with trauma and bleeding that required activation of a major hemorrhage protocol.
Finally we look at a paper which describes a taxonomy of key performance errors in intubation and may inform our review and improvement of intubation in the ED.
Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom!
Simon & Rob
Next Episode
December 2023; papers of the month
We've talked about Aortic Dissection before in our Roadside to Resus episode and the huge difficulties in picking out these rare but potentially devastating cases and this month we've got a fantastic paper on the topic! The DAShED study looks at patients presenting with symptoms that could be suggestive of aortic dissection and helps us understand the diagnostic challenge and approach to acute aortic syndrome, along with testing the characteristics of a number of decision tools.
Next up we look at a paper from Bendszus, an RCT of medical versus thrombectomy and medical treatment for acute ischaemic strokes with a large infarct, with some really powerful results.
Finally we look at a paper that shows some staggeringly different ROSC rates for patients in cardiac arrest depending on the size of the ventilation bag used!
Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom!
Simon & Rob
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