A great turnout for the first Footscray session!
A massive thanks to Dr Zeff Koutsogiannis for enlightening us on the usefulness of ABGs and cardiotoxic drug ingestions.
ABGs
6 easy steps
1-2-3-4 rule
causes of metabolic acidosis – CAT MUDPILES (you fill it in!)
osmolar gap – make sure osmolality and UEC are requested at the same time
lactate gap – compare the lab lactate measurement with blood gas machine measurement, consider “glycolate” a metabolite of ethylene glycol
CARDIOTOXIX DRUG INGESTIONS
SALT NaBicarb – give as a bolus in TCA OD (not an infusion)
SUGAR High dose insulin-dextrose to improve pump function in BB and CCB OD
COLOUR Methylene blue for profound hypotension despite fluid, available from theatre 1-2ml/kg/hr
FAT Intralipid only for LA injection with CVS toxicity
QT measurement – 3 limb leads, 3 V leads, take the MEDIAN measurement then plot on QT nomogram to determine likelihood of developing torsades
TAPNA Australasia Toxicology Network Scientific Meeting April 27-29, 2017
