A 25-year-old patient presents with significant wheeze and shortness of breath after accidental inhalation of vapour whilst cleaning a bathroom. On arrival in the Emergency Department continuous nebulized salbutamol was commenced.
This arterial blood gas was taken 6 hours into the treatment.
Parameter |
Patient Value |
Adult Normal Range |
FiO2 |
0.4 |
|
pH |
7.27 |
7.35 – 7.45 |
pO2 |
70 mmHg (9.2 kPa) |
|
pCO2 |
36.0 mmHg (4.7 kPa) |
35.0 – 45.0 (4.7 – 6.0) |
SpO2 |
93% |
|
Bicarbonate |
16.0 mmol/L* |
22.0 – 26.0 |
Lactate |
8.8 mmol/L* |
0.5 – 1.3 |
Sodium |
145 mmol/L |
135 – 145 |
Potassium |
2.9 mmol/L* |
3.5 – 5.0 |
Chloride |
111 mmol/L* |
95 – 105 |
Glucose |
9.7 mmol/L* |
3.5 – 6.0 |
Explain the results and give reasons for the abnormalities, showing your calculations where appropriate. (30% marks)
Not available.
The abnormalities are:
The possible explanations are:
Jones, Frederick L. "Chlorine poisoning from mixing household cleaners." JAMA 222.10 (1972): 1312-1312.