TAILIEUCHUNG - ADVANCED PAEDIATRIC LIFE SUPPORT - part 9

Naloxone Naloxone chất đối kháng mạnh dạng thuốc phiện có IS. Nó đối kháng với trầm cảm, thuốc an thần hô hấp, và tác dụng giảm đau của thuốc phiện. Nó là nhanh chóng chuyển hóa và tốt nhất là nuôi Because Of Với CNTT-TT nhanh chóng khai thác gan đầu tiên đi SAU Thông qua đường uống | ACID-BASE BALANCE An easy method for blood gas interpretation Step 1 Assess the pH. Is it raised 7-44 alkalosis or lowered 7-36 acidosis This is the overall status of the patient regardless of compensatory mechanisms. Step 2 Acidosis Alkalosis Respiratory CO2 t CO2 ị Base excess ị Base excess t Metabolic or or Bicarbonate ị Bicarbonate t Look at the CO2 on the chart above. If the CO2 provides a cause for the abnormal pH . low pH and high CO2 acidosis and high pH with low CO2 alkalosis then the overall picture is a respiratory acidosis or alkalosis. If the CO2 does not provide a cause for the pH it is compensating for a metabolic abnormality. Step 3 Confirm your findings by looking at the base excess of bicarbonate. If the base excess provide a cause for the abnormal pH . low pH with negative base excess acidosis and high pH with positive base excess alkalosis the overall picture is a metabolic acidosis or alkalosis. If the base excess does not provide a cause for the pH it is compensating for a respiratory abnormality. Example In a patient with shock showing sighing respirations pH 7-24 PCO2 31 HCO3 14 BE -8 The pH is low showing acidosis. The PCO2 does not provide a cause for the abnormal pH a low CO2 indicates a respiratory alkalosis not an acidosis therefore it is compensating for a metabolic acidosis. The base excess accounts for the abnormal pH a negative base excess indicates a metabolic acidosis . Therefore the patient is acidotic. He or she has a metabolic acidosis which is being partially compensated by a respiratory alkalosis. Precautions when taking an arterial blood sample The taking of arterial blood samples is described in Chapter 23. Certain errors must be avoided 266 ACID-BASE BALANCE Ensure an adequate sample and avoid bubbles. The dead space in the syringe will allow CO2 and O2 to diffuse in or out of the sample. Seal the syringe with a plastic cap for the same reasons. Avoid excess heparin. Fill the dead space of a 2 ml syringe and attached

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