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oxygen concentration, and with the clinical picture there should be
a low threshold for ITU review.
Further ABGs should be obtained. Life-threatening asthma is
said to be present when the PaO 2 is below 8 kPa and the PaCO 2
moves into the normal range or higher. In this situation, the patient
is hypoxic and is beginning to tire and may be in need of respira-
tory support.
Asthma is a disease which still has a high mortality rate, especially
in young people, so have a low threshold for senior review.
Further reading
Driscoll P, Brown TA, Gwinnutt CL, Wardle T. (1997) A Simple Guide to Blood
Gas Analysis . BMJ Publishing Group, London.
Hennessy I, Japp A. (2007) Arterial Blood Gases Made Easy . Churchill
Livingstone, Edinburgh.
Longmore M, Wilkinson I, Torok E. (2001) Oxford Handbook of Clinical
Medicine , 5th edn. Oxford University Press, Oxford.
Handy hints/troubleshooting
Compensation for metabolic acidosis is through hyperventilation,
in diabetic ketoacidosis (DKA) patients who have a rising CO 2 are
tiring and are dangerously unwell.
Remember the inspired oxygen (FiO
2 ) when interpreting the PaO 2 .
Patients will die from hypoxia before hypercarbia; don't be scared
of giving oxygen.
In a patient with a good radial pulse, call for help if you have
missed it twice.
In a patient with a weak pulse, think about the calling the
emergency medical/arrest team.
Find a patient label before taking the sample and jot down the
patient's inspired oxygen and temperature.
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