Okay, so now we've kind of
laid down the groundwork for that,
you understand what pH is, you know
what the normal pH is 7.35 to 7.45
We've looked at CO2 - it's controlled
by the lungs, normal level 35 to 45 (mmHg)
We've looked at bicarb which is, we're gonna say controlled
by the kidneys, it's really the whole metabolic system.
Normal levels are 22 to 26 (mmol/L).
Now we're gonna start at the end.
The end product of where your patient is 1 of 4
places, just like your favorite multiple choice test.
Right we have respiratory
acidosis or metabolic acidosis,
you have respiratory
alkalosis or metabolic alkalosis.
Now just knowing those names, we can
see all kinds of things about your patient.
So let's look a t the names
and see what's involved.
Let’s look at respiratory acidosis.
So, the name tells us whose fault it is because we're
in respiratory acidosis, we know it's the lungs' fault.
Acidosis tells you where we are.
Again, look at that couch again.
If we're saying that their pH is acidotic, that
means that it's not between 7.35 and 7.45,
it's somewhere beyond off
that couch, so it's lower than 7.35
Now to help you remember this, you
might want to write the values of the pH again
in on your own notes over
the couch of homeostasis.
So the patient is in respiratory acidosis
that means its the lung's fault that we got there
and where we are is acidosis,
so your pH is less than 7.35
Now for those of you that are already raising a hand, I
want to give you question just to see if you understand.
If it's the lung's fault that we're in
acidosis, what do the lungs control?
Okay, so would it take a higher CO2 level or
a lower CO2 level to become more acidotic?
Right, it would take a higher CO2 level.
Well that would mean, are my lungs breathing
way too fast? or not sufficiently enough?
In order for CO2 to build up, that
means my lungs are not hyperventilating,
for some reason I'm
not breathing effectively.
Now it could be that (muffled)
they're trying to strangle me
or it could be that you've taken too many
opiates and so you're breathing really is shallow
or could be an asthma attack
or maybe a COPD attack.
Any one of these things that cause me to
breathe inefficiently will cause CO2 to build up.
The more CO2 that builds up, the
more acidotic my pH will become
That's why I showed you the couch
and got you to move in that way.
Okay now what about metabolic alkalosis?
Well I know the first part the
name tells me whose fault it is.
So if it's metabolic, right that's
the kidneys and the bicarb level.
if I'm alkalosis, where are we on the couch?
are our pH less than
7.35 or greater than 7.45?
Good deal, it's greater
than 7.45, we're in alkalosis.
So metabolic alkalosis, that tells us the reason
we're in alkalosis is the metabolic systems' fault.
Okay, so normal values 7.35 to 7.45,
35 to 45 (mmHg) for CO2, 22 to 26 (mmol/L) for bicarb.
I know you've heard those
over and over and over again.
That's because I want you
to study as you go with us.
In that way, you'll all know
these by the end of the video