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Hs and Ts for Cardiac Arrest | Hydrogen Ions, Acidosis | Nashville CPR

By at November 15, 2012 | 8:10 pm | Print

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 and correct the acidotic condition.


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 (form of hyperventilation, deep, labored, gasping)
  • lethargy/stupor
  • ABG results pH below 7.35 and Bicarbonate level less that 24mEq/L


Treatment of the underlying symptoms

Endotracheal intubation and mechanical intubation to ensure adequate respiratory compensation

Intravenous administration of Sodium Bicarbonate

**If 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 reduction in alveolar ventilation either from acute or chronic lung conditions (PE vs. COPD)


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 of the underlying symptoms

Endotracheal intubation and mechanical intubation if needed

Intravenous administration of Sodium Bicarbonate (severe cases)

Dialysis to remove toxic drugs


Removal of Foreign body if appropriate



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