Respiratory Therapy - DKA Case Study

[@Lovely-ku9rn]

This video was 3 years ago and is still much needed! I'm so happy to have found this channel. Thank you so much, coach! 🙌🏼

[@LolitasCrafts]

Thank you for this video. One of my weaknesses is the ABGs. I can read them but I’m having a hard time connecting the results to the clinical setting to view the whole picture. I appreciate any other videos you may post like this. 👍🏼

[@RespiratoryCoach]

Cool! At least you know your weaknesses. That's the first step in turning them into strengths. I'll be sure to post more like this as they come my way. Thank you for watching!!!

[@mikeoldcoach4280]

I love watching your videos, I'm no new grad. Completely agree with everything you're saying, seen this so many times. Not sure I agree that's a room air ABG, trying to remember what the number is when you add the O2 and Co2 on RA. I love this scenario, most therapists don't understand this. Keep up the great videos........

[@RespiratoryCoach]

You're right 153 on room air is essentially impossible. Alveolar air equation says that (760-47).21- (PaCO2 9.9 x 1.25)= 137. So yeah, not sure about that. The scenario was presented to me on room air. Thank for your words of encouragement. They mean alot coming from an experienced RT. Don't hear from experienced RTs very often on this channel. Thank you for the kind words and for watching.

[@mcclintonthomas]

Thanks for this. Love learning more everyday. Now I know what to do and how to think through situations like this.

[@RespiratoryCoach]

Anytime! You know what's crazy is that the patient had been in the ER for 3 hrs (sitting on a 6.88 pH) at the time you were called to draw the gas. Wow!!!! Keep asking these great questions and learning from these real life scenarios.

[@mcclintonthomas]

@@RespiratoryCoach that's what I said Joe, three hours is a very long time. I asked had he been breathing like that the whole time and they said that he had. RR was about 32

[@mcclintonthomas]

Pt was definitely on room air. Had been in ER for some time by the time they called me to do an ABG. Pt was on RA when I arrived and was told by nurses pt was there for 3 hrs and on NO O2.

[@RespiratoryCoach]

There we have it. It makes sense severe DKA, patient was Kussmaul Breathing, Co2 super low, O2 super high. Textbook findings! Great case study. Thanks for sharing McClinton.

[@achyutgawade1668]

Thank you and you should have initially explained why is body hyperventilating to compensate acidosis

[@brianimdieke5580]

Great vid coach.. could you do a video on Winters Formula/ targeting EtCO2?

[@RespiratoryCoach]

On the list! It's a long list, but I've got your request on it! Thanks for watching and commenting!!

[@ezekielpark6918]

Thank you

[@kylereece6761]

When a pH like this cause the oxyhemoglobin dissociation curve to shift far to the right? And if so his po2 would be somewhat normal because that would be what is needed to saturate the hemoglobin? I'm just trying to think of many different things that can be happening in something like this.

[@RespiratoryCoach]

Hey Kyle. You're 100% correct.

[@dizzypancreaspump]

I've had multiple ph of 6.9's, a bicarb of 2, and an AG of 32 at different points. Myself/multiple dka

[@thatthiskitchen8193]

Great explanation!

[@RespiratoryCoach]

Thank you, Nandasiri! Again I appreciate you watching and commenting!

[@romaissabrt1669]

Thank you so much for your great work , I have a question please , i got the same scenario in my last shift DKA when we deal with the case we managed the problem we found that the patient have hypoventilation and hypocapnia ,the problem is if I let this hypocapnia to rest long time in order to rise my ph ,also the hypocapnia is dangerous for cerebral flow ,it makes vasoconstriction ,i m afraid if i worsen her neurological score ? I appreciate any explanation.

[@cyriljum5182]

Thank you! it helps a lot.

[@RespiratoryCoach]

You are very welcome! Glad it helps. Thanks for watching and for commenting. I appreciate you!

[@brindamohabir8432]

Of course bicarbonate should be given. This ph has to be corrected immediately