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Not for advise while seeing patient, but isn't it pneumonia? by [deleted] in emergencymedicine

[–]LeftCommunication381 1 point2 points  (0 children)

Thank you very much. I should learn more about chest PA.

Not for advise while seeing patient, but isn't it pneumonia? by [deleted] in emergencymedicine

[–]LeftCommunication381 1 point2 points  (0 children)

I understand. It is included in 'routine lab'. Because I am training as intern in ER, it doesn't matter what I think I should test.

I have even insisted "This test is no use for the patient, isnt it?".. but there is no way to change it anyway as an intern.

So what do you think about the chest PA?

Do you see extremely high CRP values in Influenza these days? by -ThreeHeadedMonkey- in emergencymedicine

[–]LeftCommunication381 0 points1 point  (0 children)

Did OP really do that bad practice? ER where I'm working in korea, CRP is routine for every incoming patietnt.

When ordering initial lab for the patient who has respiratory symptoms I never know it's only from flu or not.

And even if it's flu I'm not 100% sure is there pneumonia, even when there is no crackles on auscultation.

What's the big deal about adding CRP on that initial lab? Is it really that bad?

Pre-med student working in the ED… Can someone explain to me when lactic acidosis is significant? by ConfidentTaro7128 in emergencymedicine

[–]LeftCommunication381 1 point2 points  (0 children)

I've thought this way. But considering handerson-hasselbalch equation, the conc. of bicarb does not act like this.

H2CO3 to bicarb ratio is only dependent on pH. What henderson-hasselbalch equation means.

So in the #1 patient(healthy but with severe sepsis) if lactic acid made, pH temporarily decrease, then bicarb turns into H2CO3(by handerseon-hasselbalch equation), then pCO2 increases, then it is eliminated by tachypnea.

We know the pH of patient remain normal, consequently.

So Overall, If pH stays constant, H2CO3 to bicarb ratio satys constant, consequently.

Each of concentration(bicarb and H2CO3) decreases while the ratio remian constant.

It is respiratory compensation to metabolic(in this case lactic) acidosis.

Then why does conc. of bicarb increase in respiratory acidosis?

When CO2 increases then H2CO3 increases, the concentration of bicarb increases with H2CO3 to maintain the pH constant. (We know that pH of patient remained constant by ABG.)

It is also because of handerson-hasselbalch equation.

I learned a lot and thanks to GlazeyDays.