Listen to the Podcast
In this episode the quantitative approach to acid-base interpretation is explained with examples of how to perform the calculations at the bedside. For further learning I suggest visiting the Acid-Base section on the EMCrit Website. Details of the Acid-Base Calculator App can be found below.
Acid-Base Calculator App
Here are the codes to download a copy of the Acid-Base Calculator App on iOS for free (unfortunately there is no way to give away a free copy for android at present). Each code can only be used once and are on a first come, first served basis. To prevent others from trying to redeem a code that has already been used, please leave a comment that you have used the code.
Promotional Codes
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779NY7WAYEK3
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AM7F7F3NMKE7
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WET7TMJL3LT9
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RN3RTLM9JRPW
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EW76R9F7FHXT
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PT9RLMYHAJY4
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PAF49WTHY3L3
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TN6AR4PJ6FJY
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3AKJ46AW6W9H
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77HH9YN7JHMW
Redeeming the code
- Open the ‘App Store’ on your iPhone/iPad/iPod Touch
- Click on the featured tab in the bottom left hand corner
- Scroll to the bottom of the ‘Featured’ page and click on ‘Redeem’’
- Follow the instruction to enter your promotional code to download the app for free
- The code will expire in 28 days if not used
Thank you I used the bottom code (number 10).
779NY7WAYEK3 (1st code) used. Great app. Thanks for your great work.
Another great podcast. Many thanks. I’ve found it really useful. In fact I’ve just been looking at the gases of a DKA patient we admitted overnight and worked out that the second gas had a worse pH but improving ketosis. I plan to give a talk to the paediatricians in my local DGH to spread the knowledge (I’ll also plug the website).
Missed deadline for promotional codes unfortunately 🙁
Hi Richard, Glad you found it useful. Here is a new code APXNR4R9KLHL for the app.
Regards
Chris
This is the most useful paediatric podcast i’ve listened to for some time, thank you.
I have a question With regard to hyperchloraemic metabolic acidosis in DKA with fluid therapy. When still needing insulin infusions, is this something that just has to be “lived with” rather than adjusting to hartmanns, in the context of the protocolised BSPED DKA guidelines and its advice of reducing risk of cerebral oedema by looking for a rise in corrected sodium during treatment? And also in terms of how to ensure enough potassium is being provided while on insulin infusions
Hi Dilshad,
Thanks for your comments. The BSPED DKA guidelines are very prescriptive regarding prescription of fluids and I think this is a good think, like you mention you will need more potassium than is contained in Hartmann’s to keep the serum potassium in the normal range while on insulin infusion and adding potassium to a bag of Hartmann’s isn’t worth the risk of error when you can use a ready made bag of saline or dextrose/saline with this amount of potassium in it. Also importantly the hyperchloraemic acidosis doesn’t do the patient any harm you just need to track how much of the acidosis is coming from ketones and how much from chloride and as long as the part coming from the ketones is improving then don’t worry about it. What people who don’t understand the quantitative approach to acid-base interpretation will do is turn up the insulin infusion or give more acidic fluids in an attempt to treat the problem (which will have no effect or make things worse). Other thing the guidelines do need to address is the patient who has no ketoacidosis, but has a low pH due to chloride, where the guidelines recommend keeping going with DKA protocol till pH is normal (they don’t differentiate between low pH due to Cl and due to ketones).
Excellent podcast. You have greatly simplified a complex topic and it makes so much sense. Thanks.
Hi Rizwan, nice to hear from you and I hope you are keeping well. Glad you found it useful.
Hi Dr Flannigan, Thank you so much for a wonderful podcast! Listening to your podcasts fires me up on my way to work. I am hailing from Malaysia and working in pediatrics- yet have limited exposure to pediatric intensive care. Your podcasts have helped a great deal in helping us deal with sick kids 🙂 Keep up the great work and have a wonderful day!
Hi Ping, appreciate you taking the time to get in contact. Glad to hear you find them useful and that they help when caring for sick kids – thats why I do this, so thanks for letting me know. Best wishes, Chris
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I love all your Podcasts but this one is a definite favourite of mine. I have recommended them far and wide.
Would it be possible to get an update on the codes for the acid base calculator? Or is there a way to integrate it with the Paed emergencies app (another favourite of mine).
Thank you
Such an excellent talk. I will try to apply the calculations to the blood gases I read on PICU. Thank you. The consultant quickly glossed over acid base on ward round, so I’m really glad you explained it in such detail with the worked through examples.