Handbook of Blood Gas/Acid-Base Interpretation

Blood gas analysis has become the ‘‘. . . single most helpful laboratory test in managing respiratory and metabolic dis- ders. (It is). . . imperative to consider an ABG for virtually any symptom. . . , sign. . . , or scenario. . . that occurs in a clinical 1 setting, whether it be the clinic, hospital, or ICU. ’’ For the uninitiated, the analysis of blood gas can be a daunting task. Hapless medical students, badly constrained for time, have struggled ineffectively with Hasselbach’s m- ification of the Henderson equation; been torn between the Copenhagen and the Boston schools of thought; and lately, been confronted with the radically different strong-ion approach of Peter Stewart. In the modern medical practice, the multi-tasking health provider’s time has become precious―and his attention span short. It is therefore important to retain focus on those aspects of clinical medicine that truly matter. In the handling of those subjects rooted in clinical physiology (and therefore predic- bly difficult to understand), it makes perfect sense, in my opinion, to adopt an ‘algorithmic’ approach. A picture can say a thousand words; a well constructed algorithm can save at least a hundred―not to say, much precious time―and make for clarity of thinking. I have personally found this method 1 Canham, EM, Beuther, DA, Interpreting Arterial Blood Gases, PCCU on line, Chest vii viii Preface relatively painless―and easy to assimilate. The book is set out in the form of flow charts in logical sequence, introducing and gradually building upon the underlying concepts.