SAQ 1765 – Paediatric vomiting with venous blood gas

A 2-year-old girl is brought to ED after 24 hours of frequent vomiting. Her venous blood gas is shown.

VBG	Result	Reference range
pH	7.54	7.35-7.45
pCO2	48 mmHg	35-45
HCO3	42 mmol/L	22-33
Base excess	+7 mmol/L	-3 to +3
Na	140 mmol/L	135-145
K	4.0 mmol/L	3.5-5.2
Cl	75 mmol/L	95-110
Glucose	4.4 mmol/L	3.0-7.8
Lactate	1.8 mmol/L	0.5-2.2

Interpret the results by completing the tables for primary disturbance, secondary disturbance and degree of compensation.

(Marked out of 6.0)

/ 6

List four potential surgical causes for her presentation, including a discriminatory history or examination finding for each.

(Marked out of 8.0)

/ 8

Your diagnosis is viral gastroenteritis. The child is moderately dehydrated, has not tolerated oral rehydration, and weighs 15 kg. Prescribe nasogastric rapid rehydration.

(Marked out of 3.0)

/ 3

State two advantages of nasogastric rehydration compared with IV fluid rehydration.

(Marked out of 2.0)

/ 2

List four criteria you would seek before safe discharge home.

(Marked out of 4.0)

/ 4

Total Score: 0 / 23

Percentage: 0%