A 22-year-old patient arrives in your clinic by ambulance. The emergency medical

Question

A 22-year-old patient arrives in your clinic by ambulance. The emergency medical technicians tell you that his friends found him unresponsive with a needle in his arm and called for an ambulance. He is found to have slow, shallow breathing and has an arterial pCO2 of 80 (normal = 40) and pH of 7.08 (normal = 7.40). A member of the ambulance team sticks around for a while and asks you why you didn’t give the patient HCO3- to resolve the patient’s low pH. You tell her that

A 22-year-old patient arrives in your clinic by ambulance. The emergency medical technicians tell you that his friends found him unresponsive with a needle in his arm and called for an ambulance. He is found to have slow, shallow breathing and has an arterial pCO2 of 80 (normal = 40) and pH of 7.08 (normal = 7.40). A member of the ambulance team sticks around for a while and asks you why you didn't give the patient HCO3 to resolve the patient's low pH. You tell her that O the patient's acidosis was likely caused by surreptitious HC03. injection and therefore more HC03. would have exacerbated the problem. and CO32, worsening his acidosis. bicarbonate administration would only increase the already high pCO2 O addition of bicarbonate would decrease PO2

Explanation / Answer

Answer: bicarbonate administration would only increase the already high pCO2

Explanation: Upon bicarbonate addition to blood, there would be an increase in pCO2. This increase is proportional to the existing blood pH.

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