I have spoken about it for a while, but I’ve finally gotten it done: the acid-base podcast. The podcast is going to be in 3 or 4 parts. They are segmented from a lecture I gave to my residents recently. Part II discusses the mathematics of acid base and Part III goes through actual problems. Part IV then discusses the acid-base of administered solution.
This lecture discusses a quantitative approach to acid base management. This is also known as the Fencl-Stewart approach, the strong-ion approach or the physicochemical approach. It provides explanations for why acid base disorders occur in human pathophysiology. The classic method used in the USA is the Henderson-Hasselbalch (misspelled on my slides) approach. I find this method to provide no comprehensive explanation for why things are as they are. Through the quantitative approach, you can also understand the H&H approach and continue to use it with new insight.
This first part deals with the preliminaries. Part II will go into clinical applications.
After listening to the podcast, I recommend reading this article:
Kaplan LJ,Frangos S. Clinical review: Acid–base abnormalities in the intensive care
unit. Critical Care 2005;9(2):198
For the next part of the series, you will need a print out of this sheet:
EMCrit Acid-Base Sheet
Want to read more?
Need an Audio Only Version?
Acid Base Part I MP3 [Play] (Right Click and Choose Save as)
…
Podcast: Play in new window | Download (43.8MB) | Embed
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Hey Scott,
From what I can tell, the first day your new Podcast comes out, it is not yet on the i-Tunes list. So the only way to listen to it is as a quicktime file on my PC. Is there another way? I usually just have to wait painfully to see that i-tunes has your latest but this is sometimes a day or two. Thanks for your hard work!
Matt
Refresh button on the bottom right of your itunes podcast screen will cause instant updates.
(Na + K+ Mg + Ca) – (Cl + lactate) = Answer to the Ultimate Question of Life, the Universe, and Everything
(when SID is normal)
C
I thought 42 was the ultimate answer to everything; remember your towel.
Exactly (if you fudge the numbers a little)
C
Scott,
No mp3 version????
Mike
Added inside the post, just for you Mike.
Thanks Scott,
I am I-literate! But I have a towel
Mike
Great first part of the acid-base lecture. In fact, great website overall.
I start 3rd year of med school in July, and these lectures will no doubt improve my understanding of medicine and what goes on in the hospital.
Thanks!
Zach, thanks for the feedback. Get back to us and let us know how this version of acid-base fits in to what you learned years 1-2.
scott
Here they teach us H-H pretty religiously. What’s CO2 doing? What’s bicarb doing? What’s the pH? A little bit on anion gap. It all stays pretty superficial, and every discussion leaves you wanting more.
So, it’s nice to get a fresh perspective on the topic. Thanks again.
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Hey Scott:
I light of this paper, do you guys still use NS at Hurst, or are you prefering LR. Just curious.
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This lecture is very helpful for my understanding of Acid/base coming from a 1st year. I really enjoy coming to the website to clarify and solidify many of the concepts we are covering in class.
thanks for the feedback, Christopher.
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