SAQ 1466 – Febrile child with respiratory symptoms and abnormal VBG

A five-year-old boy is brought to your ED with two days of fever, cough and lethargy.

Chest examination shows reduced breath sounds and crackles at the right base. A venous blood gas has been taken.

Observation	Value
Temperature	38.8 degrees C
Pulse	145/min
BP	90/40 mmHg
Respiratory rate	40/min
O2 saturation	91% on room air

Parameter	Result	Reference range
pH	7.18	7.35-7.45
pCO2	21 mmHg	35-45 mmHg
pO2	25 mmHg	80-100 mmHg
HCO3	8 mmol/L	22-32 mmol/L
Base excess	-18.5 mmol/L	-3 to +3 mmol/L
Sodium	140 mmol/L	135-145 mmol/L
Potassium	5.7 mmol/L	3.5-5.0 mmol/L
Chloride	98 mmol/L	100-110 mmol/L
Glucose	38 mmol/L	3.0-7.8 mmol/L

In point form, explain all abnormalities shown on the venous blood gas.

(Marked out of 8.0)

/ 8

State your diagnosis based on all the clinical information.

(Marked out of 2.0)

/ 2

List your five main treatment steps, including drugs and doses where appropriate.

(Marked out of 5.0)

/ 5

Total Score: 0 / 15

Percentage: 0%