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VBG vs ABG

Notes: In a meta-analysis, Bloom et al. note that there is good correlation between arterial and venous pH and HCO3. They also concluded that despite variability in arterial and venous pCO2 and lactate, normal venous levels have good negative predictive values. 1 Zeserson et al. studied VBG and SaO2 (pulse oximetery) results in critically ill patients. This population included 41% ED,

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Hypokalemia

Hypokalemia <3.5 mmol/L Severe < 2.5 mmol/L ECG changes ST depression U wave QT prolongation (>450 ms) PVCs AV block Bradycardia Vtach Vfib Treatment- Replacement Each 10 mEq raises K 0.1 mmol/L PO replacement preferred ECG changes require admission and IV + oral replacement. Magnesium replacement is also indicated. Many foods contain potassium. Replacement need not be tablets only. See list here. Symptoms

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Hyperkalemia

Hyperkalemia >6.0 mmol/L EKG changes (not necessarily in order, especially if chronic renal failure patient) Peaked T waves PR prolongation Short QT (<350 ms) Widened QRS Flat P waves Heart Block Sine wave V. Fib. Treatment: Stabilize, Shift, Excrete Stabilize: Calcium stabilizes myocardial membrane with onset in 15-30 minutes. Calcium gluconate IV 10 ml of 10% solution over 10 minutes may cause

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CT Contrast and Kidneys (FAQ)

American College of Radiology Manual on Contrast Media (download pdf): 1) Do end-stage renal patients need urgent dialysis after a CT scan with IV contrast? No “Most low-osmolality iodinated contrast media are not protein-bound, have relatively low molecular weights, and are readily cleared by dialysis. Unless an unusually large volume of contrast medium is administered, or there is substantial underlying

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