1. Look at pH
  2. Assess primary cause - look at HCO3/CO2/BE
  3. assess for mixed disturbance (DONT SAY COMPENSATION)

<aside> 💡 Metabolic Compensation 1245 rule calculate **expected change in HCO3

acute resp acid:** expected change HCO3 = (actual CO2-40) x 0.1

acute resp alk: expected change HCO3 = (actual CO2-40) x 0.2

chronic resp acid: expected change HCO3 = (actual CO2-40) x 0.4

chronic resp alk: expected change HCO3 = (actual CO2-40) x **0.5

24 + ans = expected HCO3 expected > actual = met acidosis expected < actual = met alkalosis**

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<aside> 💡 Respiratory Compensation Metabolic acidosis (Winter’s formula) Predicted CO2 = (1.5 x HCO3-) + 8 +/- 2

Metabolic alkalosis (...?Summers formula?) Predicted CO2 = (0.7 x HCO3-) + 20 +/- 5

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<aside> 💡 if metabolic acidosis do anion gap AG= Na-(Cl+HCO3) normal is 4-13

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ranges for compensation

HCO3 18-28 (acute) 15-45 (chronic)

chronic respiratory acidosis, you will expect to see an elevated HCO3 and BE

CO2 or 10-55

Things on ABG

always