Come November …..

“Haven’t you written  anything new “ Saima Kamal asks.So people are reading my blog, my heart bumps and jumps!

 

 

 

 

 

 

 

With the month of November, this doc is to rotate in Oncology…. after three months of oncology (i.e. July --- September) I tell Dr Tayyaba that “I really enjoyed Onco “, she smiled and said “well maybe you should continue for another month then “. “NAAAH! “ I thought then…….. The month of Pulmonology was a bliss.

My first call in oncology , 28 patients……the night before, Dr Tayyaba told me to perform prayers before my call so that I admit only a few patients ( not the bundle that I m notorious for ).I do exactly that.But Allah wants me to multitask  . . .

My eyes scroll through one of the patients blood gas. I know how to interpret this, I think.

There are six steps

1. Check internal consistency
2. Ascertain whether there is acidaemia/alkalaemia
3. Find out whether the defect is metabolic / respiratory
4. Check for compensation
   • For metabolic acidosis: Pco2 = (1.5xHCO3) + 8
   • For metabolic alkalosis: Pco2 = (0.7xHCO3)+21
   • For respiratory acidosis
     • for acute increase of pCO2 of 10 mmHg , bicarbonate should increase by 1
     • for chronic increase of pCO2 of 10 mmHg, bicarbonate should increase by 3
   • For respiratory alkalosis

   • for acute decrease of pCO2 of 10mmHg, bicarbonate should decrease by 2
   • for chronic decrease of pCO2 of 10 mmHg, bicarbonate should decrease by 5.

5. If metabolic acidosis , calculate anion gap
6. If high anion gap, calculate delta gap.

 

But no . .. . . . . .  .I dont have the time for this meticulous calculation! I just flip the page containing the ABG’s…..

The story continues……..