Question : For the following scenario please answer in point form:??1. State the presence or absence of acidaemia, ?2. State the types of alkalosis/acidosis present?3. State the most likely diagnosis?4. Outline treatment strategies employed to stabilise patient for transport to a tertiary facility. Initial Information: (Used paramedics Guidelines to cover this scenario )
?A 75 year old man is on the surgical ward 2 days after a laparotomy for a perforated sigmoid??colon secondary to diverticular disease. He has become hypotensive over the last 6 hours.??His vital signs are: • Heart rate 120/min – sinus tachycardia – warm peripheries • Blood pressure 70/40 mmHg • Respiratory rate 35 breaths/min • SpO2 on oxygen 92% • Urine output 50 mL in the last 6 hours • GCS 13 (E3, M6, V4) . . Arterial blood gas analysis reveals: (Normal values in brackets)? • FiO2 0.4 (40%) approx • pH 7.12 (7.35 – 7.45) • PaCO2 34 mmHg (35 – 45 mmHg) • PaO2 62 mmHg (75 mmHg) when breathing air • HCO3- 12 mmol/L (22 – 26 mmol/L) • BE – 15 mmol/L (+/- 2 mmol/L)
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