【App】ABG Expert－初學者對答案必備

Winter Surge 又到啦，各位有幸抽中第三水做medical嘅houseman又可以一展你哋抽ABG嘅技巧啦！想當年小弟一月一日就oncall，仲要得兩個人坐晒成間中型醫院嘅內科病房，做到夜晚都未抽得切朝早order嘅ABG，真係令人懷念......


當你幾經辛苦著住PPE焗住個N95搏鬥完一輪抽咗支blood gas，點樣interpret個result呢？半夜三更你個腦又唔係好function到，call MO 問又怕俾人鬧，唔使怕！拎出你部電話，開個app出嚟就interpret到啦！

[iTunes] ABG Expert

只要輸入blood gas result，例如pH, PaCO2, PaO2, FiO2, Na, K, Cl, lactate 等等, 佢就會俾到個結果你。例如 22/F known T1DM presented to A&E for SOB with generalised discomfort.

ABG:
pH 7.05,
PaCO2 2kPa,
Na 129mmol/L,
K 5mmol/L,
Cl 96mmol/L,
HCO3 5mmol/L

佢會話比你知呢個係high anion gap metabolic acidosis，你仲可以撳落去high anion gap嗰度，佢會教埋你點計，同埋最重要嘅differential diagnoses：

acid overproduction: ketoacidosis, lactic acidosis
acid underexcretion: chronic renal disease
impaired lactate clearance: advanced liver disease
massive rhadomyolysis
toxic etiologies: panadol, beta agonists, valproate

仲有further tests to consider e.g. urine toxicology, serum and urine ketone, serum beta-hydroxybutyrate, serum ethanol, serum osmolarity...

咁你諗掂晒order埋先inform MO，佢應該都唔會燥你底啦掛？

佢仲有個功能去計ventilator optimisation，不過小弟甚少要較機，就唔班門弄斧啦，大家可以試下用唔用得著。

抽ABG嘅技巧就可以參考下呢篇文啦：[Intern 入門] Arterial blood taking