Auto Injury : A Case Study in Acid-Base Balance
Mr. Wilson , a 60-year-old male, was on his way home from work after snowing all day. Mr. Wilson slide on the icy street through a red light where he was hit by an oncoming truck. The other driver suffered only minor bruises and cuts, Mr. Wilson demonstrated labored breathing and severe chest pain. Mr. Wilson was in the trauma centers ER in less than 2 mins. Mr. Wilson had experienced blunt trauma from the impact of the steering wheel after the airbag failed to deploy.
Mr. Wilson examination revealed, blurred vision, dizziness, headache, nausea, muscle weakness, hypoventilation, and a feeling of mental confusion. A Ct scan revealed bilateral fractures in the fourth, fifth, and six ribs and a possible hemothorax. An ECG revealed signs of ventricular arrhythmias. The values following values were taken from the results of an arterial blood gas (ABG) and urinalysis (UA).
Aterial Blood Gas (ABG) High or Low
pH: 7.1 Low
Pco2: 58 High
bicarbonate: 33 mEq/L High
pH: 3.7 Low
Short Answer Questions
1.bilateral - involving both sides
hypoventilation - slow breathing due to accumlation of co2
Hemothorax - presence of blood in the pleural cavity
Arrhythmias-abnormal ecg waves
2.normal abg values
PH of blood - 7.35 to 7.45
Pco2 - 35 to 45 mmhg
Bicarbonate - 22 to 27 meq/l
Normal urine ph - 4.5 to 8
3.the ribfracture may damage lungs or intercostal blood vessels causing hemothorax.
4.increase in pco2 cause hyperventilation increasing respiratory rate and balence this.its the primary mechanism.
In this case hyperventilation not possible due to rib fracture.
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