A 59-year-old obese man receives 5 mg of intravenous morphine for analgesia for abdominal pain. Thirty minutes later, his GCS has fallen to 12 and investigations are performed. Arterial blood gas and serum biochemistry is taken.
ABG & Biochemistry Results
| Test |
Result |
Reference Range |
| FiO₂ |
0.21 |
Room air |
| pH |
7.24 |
7.35 – 7.45 |
| pCO₂ |
92 mmHg |
35 – 45 mmHg |
| pO₂ |
45 mmHg |
80 – 95 mmHg |
| Bicarbonate |
49 mmol/L |
22 – 28 mmol/L |
| Base Excess |
+10 |
-3 – +3 |
| O₂ Saturation |
78% |
> 95% |
| Lactate |
1.2 mmol/L |
< 1.3 mmol/L |
| Sodium (Na⁺) |
142 mmol/L |
134 – 146 mmol/L |
| Potassium (K⁺) |
3.8 mmol/L |
3.4 – 5.0 mmol/L |
| Chloride (Cl⁻) |
86 mmol/L |
98 – 106 mmol/L |
| Glucose |
11.4 mmol/L |
3.5 – 5.5 mmol/L |
| Haemoglobin |
184 g/L |
135 – 180 g/L |
| Carboxyhaemoglobin |
7% |
< 6% |
a. Provide two (2) calculations to help you to interpret these results.
(Marked out of 2.0)
/ 2
b. Using the scenario and the derived values, state the primary abnormality/s.
(Marked out of 2.0)
/ 2
c. Using the scenario and the derived values, state the secondary abnormality/s.
(Marked out of 2.0)
/ 2
d. Provide a unifying explanation for these results.
(Marked out of 2.0)
/ 2
Total Score: 0 / 8
Percentage: 0%
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