Posted: September 13th, 2017

Advanced Medical Studies (Paramedics)

Advanced Medical Studies (Paramedics)

Question :
For the following scenario please answer in point form:??1. State the presence or absence of acidaemia, ?2. State the types of alkalosis/acidosis present?3. State the most likely diagnosis?4. Outline treatment strategies employed to stabilise patient for transport to a tertiary facility. Initial Information: (Used paramedics Guidelines to cover this scenario )

?A 75 year old man is on the surgical ward 2 days after a laparotomy for a perforated sigmoid??colon secondary to diverticular disease. He has become hypotensive over the last 6 hours.??His vital signs are:
• Heart rate 120/min – sinus tachycardia – warm peripheries
• Blood pressure 70/40 mmHg
• Respiratory rate 35 breaths/min
• SpO2 on oxygen 92%
• Urine output 50 mL in the last 6 hours
• GCS 13 (E3, M6, V4)
.
. Arterial blood gas analysis reveals: (Normal values in brackets)?
• FiO2 0.4 (40%) approx
• pH 7.12 (7.35 – 7.45)
• PaCO2 34 mmHg (35 – 45 mmHg)
• PaO2 62 mmHg (75 mmHg) when breathing air
• HCO3- 12 mmol/L (22 – 26 mmol/L)
• BE – 15 mmol/L (+/- 2 mmol/L)

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