For Acid Base Disorders:

• Check for internal consistency
• Use pH to determine the primary disorder
• Calculate the AG
• Determine the presence of additional disorders
• Calculate the expected pCO2 for any metabolic acidosis to evaluate for additional respiratory acidosis.

Winter’s Formula: expected pCO2 = 1.5 (HCO3) + 8 +/-2

• Remember vagal maneuvers for SVT: carotid massage, valsalva, diving reflect
• Remember the trial of DKA:
  • Hyperglycemia
  • Anion Gap Metabolic Acidosis
  • Ketonemia
• DKA management:
  • Fluids: usually 3-6L deficient
  • Insulin: 0.1 U/kg bolus followed by a rate of 0.1 U/kg/hr; adjust as needed
  • Electrolytes: watch for K and phosphate – typically appear normal initially, but are actually “total body” deplete – likely to drop quickly with insulin administration