q5 - samomcos

[ArchivalUser]

Options A, B, D, E are all values that could be seen during respiratory alkalosis consistent with an asthma attack. Although not ideal, they are signs that the patient is breathing appropriately for the situation and medical therapy can be continued without intubation.

[ArchivalUser]

normal pco2 or normal PH in this setting idicates impending respiratory failure due to exhausion

[ArchivalUser]

I dont know this question is abt indication of intubation inasthamatic
which is eithr PO2 lower than 60-70 despite O2 at 100%, altered sensorium, sever metabolic acidosis not corrected by all measures, Pco2 more than 60 mmHg, silent chest, RR more than 40 cant understnad anything fits here so I think maybe best and wud be AAAA
since it cud be sever mucucs plugging of the main bronchus and thus lowered Pco2

not sure still will go for AAAAAA tho whats the ans

[ArchivalUser]

hmmmm but is that value of pH appropriate I think one lower than 7.2 which fails to correct is an immediate indicator well ok guys check this out

http://pats.atsjournals.org/cgi/content/full/6/4/371

[ArchivalUser]

hmm.... well, like i said, i had no clue! just posted the Q and explanation...! yup, maybe 7.39 isn't bad enough, but enough to keep a watchful eye on the pt.

[ArchivalUser]

ohhh ok i get it now which of the following wud signal the need damn I thot its an indication for hahahaha I think I need some sleep now thankyou samo g8 question

[ArchivalUser]

respiratory alkalosis develope initially and progress into res acidosis if bronchospasm not relief and res acidosis is an indication for intubation and mechanical ventilation, only c is acidosis PH 7.39, the rest alkalosis. agree c

[ArchivalUser]

Goljian Page 318

[ArchivalUser]

with a RR of 28 you should expect alkalosis with decreased PCO2 and that's what was most likely present at the beginning of the attack, but when u find a normal PCO2 after that, its a sign that the patient is exhausted and starting to retain CO2.

From the choices given, a,b & d are expected in any asthma attack, so no problem with those readings........... also e is of course not worrisome. bb is the only bad sign in the choices given