CPR Nashville Brings You the Hs and Ts of Cardiac Arrest. Go here for Hypoxia.
Hydrogen ion (acidosis)
Metabolic Acidosis Defined:
State of excess acid accumulation and deficient base bicarbonate. Symptoms are a result of the body’s attempt to compensate for and correct the acidotic condition.
Causes:
anaerobic metabolism- lactic acid production, chronic alcoholism, diabetic ketoacidosis, diarrhea, low carb/high-fat diet, malnutrition, renal insufficiency/failure (kidneys regulate hydrogen ions H+ and bicarbonate ion HCO3–
Signs and Symptoms:
- drowsiness
- headache
- Kussmaul’s respirations (a form of hyperventilation, deep, labored, gasping)
- lethargy/stupor
- ABG results in pH below 7.35 and a Bicarbonate level less than 24mEq/L
Treatment:
Treatment of the underlying symptoms
Endotracheal intubation and mechanical intubation to ensure adequate respiratory compensation
Intravenous administration of Sodium Bicarbonate
**If the cause is diabetic ketoacidosis- administer insulin and IV fluids
Respiratory Acidosis Defined:
An Acid-base disturbance characterized by excess of CO2 in the blood (hypercapnia). It is the result of a reduction in alveolar ventilation either from acute or chronic lung conditions (PE vs. COPD)
Causes:
airway obstruction, CNS trauma, chronic metabolic acidosis, opioids, anesthetics, neuromuscular diseases
Signs and Symptoms:
- tachycardia, hypertension, arrhythmias
- coma
- confusion
- dyspnea and tachypnea
- headaches
- tremors
- hypoxemia
- PaCO2 exceeds 45mmHg and pH is usually below 7.35.
Treatment:
Treatment of the underlying symptoms
Endotracheal intubation and mechanical intubation if needed
Intravenous administration of Sodium Bicarbonate (severe cases)
Dialysis to remove toxic drugs
Bronchodilators
Removal of Foreign bodies if appropriate
Hypokalemia
