pHucked Up: Respiratory vs. Metabolic Acidosis
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pHucked Up: Respiratory vs. Metabolic Acidosis
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Your patient is acidotic. Fantastic. Now comes the slightly more important question: why?
In this episode of That Paramedic Podcast, we dive into the wonderfully unpleasant world of respiratory and metabolic acidosis. We break down how the body regulates pH, the roles of the lungs and kidneys, and how to determine whether the problem is caused by too much carbon dioxide, too little bicarbonate, or the human body simply deciding that chemistry is now optional.
We explore the common causes and clinical presentations of both types of acidosis, including respiratory failure, COPD, hypoventilation, shock, sepsis, diabetic ketoacidosis, renal failure, and other situations in which the patient’s internal environment has become medically described as pHucked.
We also discuss compensation, why the respiratory rate matters, how capnography and blood gases can help, and why silencing a patient’s compensatory breathing without understanding what is happening can turn a bad situation into a very short case review.
So take a deep breath, unless you are retaining carbon dioxide, and join us as we attempt to make acid-base balance slightly less confusing and considerably more inappropriate.