Case puzzler: A patient was admitted to ICU due to profound hypotension of unknown cause. What *two* clues are contained in the CBC which reveal the diagnosis? Answer In isolation, this data wouldn’t be very exciting. However, there are two things which are strange about this CBC in the context of a shocked patient. Clue […]
pseudohyperkalemia
The cause for the elevated potassium is pseudo-hyperkalemia. The key clue to the diagnosis is marked hyperkalemia with a normal EKG and telemetry tracings. The physiology behind this in this situation is potassium leaking out of platelets and WBCs within the blood tube. (Note how elevated the platelets and WBC counts are.) Other potential causes […]
acid base overview (9/11/19 talk)
talk slides respiratory acid-base The diagnostic worthlessness of (most) ABGs Converting a VBG into an ABG Extracorporeal CO2 removal vs. extreme permissive hypercapnia metabolic acid-base IBCC core information Diagnosis HAGMA (high anion-gap metabolic acidosis) NAGMA (non-anion-gap metabolic acidosis) Metabolic alkalosis Fluid selection & pH guided resus (with section on how to use bicarbonate) Other stuff […]
answers to ABG/VBG questions
Here are the answers to todays discussion questions on ABG & VBG. A woman with history of heart failure, COPD, and recent international plane travel presents with dyspnea to the ED. ABG shows 7.52/29/65/23. What does this test reveal about her diagnosis? (2/6) — josh farkas 💊 (@PulmCrit) September 4, 2019 (1) Answer = 4. […]
Troubleshooting kinked introducer
introduction / clinical conundrum A patient is admitted in transfer with a kinked introducer catheter (shown above). Does this catheter need to be removed, or can it somehow be salvaged? a few words about the introducer catheter Introducer catheters (a.k.a. “cordis” or “sheath”) are traditionally popular for hemorrhagic shock resuscitation because they have high flow […]
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