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Metabolic Acidosis

Keep Calm AND Get a Venous Blood Gas

30 June, 201511 July, 2021 EMKF

Unless you want to know a patient’s oxygenation (because your pulse oximeter has failed), stop turning your patient into a pin cushion looking for the radial artery and get a venous blood gas


Sodium Bicarbonate Therapy in Patients with Metabolic Acidosis

18 March, 201511 July, 2021 EMKF

DID YOU KNOW: “Evidence that significant harmful effects are derived from metabolic acidosis by itself has NOT been provided in human beings”

Sodium Bicarbonate does NOT treat metabolic acidosis (it just gives you numbers that make you happy about yourself while the patient dies) – Death by Sodium Bicarbonate

Please DO NOT give Sodium Bicarbonate – IT’S HARMFUL TO YOUR ACIDOTIC PATIENT – TREAT THE CAUSE

27 January, 201511 July, 2021 EMKF

Sodium bicarbonate may increase serum pH, but may worsen rather than improve prognosis.  Other than indications where sodium bicarbonate is the treatment for the acidosis (such as TCA overdose), the treatment for metabolic acidosis is to correct the underlying cause, whatever it may be.

Intubating the patient with severe metabolic acidosis

31 December, 201426 April, 2015 EMKF

How to intubate a critically ill patient and not kill them in the process…avoiding the airway clean kill

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