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Thank! Well done as usual. We do not measure the bicarbonate on the blood gas; the pH, the PC02, are measured and HCO3 is calculated by the Henderson Hassalbach equation. The venous oxygen is a source of great error...for a while in my shop the lab had actually started to use chemistry tubes for venous gas collection. That doesn't change the acid base much, or the PCO2; but gives you oxygen values that are higher than arterial?! Nobody but me complained about this. But we found the error and now they use the proper blood gas syringes. Using the SVO2 from even a good central line has some problems, compared to a mixed venous ABG from the pulmonary artery of a Swan Ganz. I tell my COVid patients to expect one stick a day in the wrist, so I can follow their oxygen, (A-a ) gradient, etc; High flow you can use saturations, FI02's, and the ROX score. Sicker ones need an arterial line. Also lots of the arcane methods of interpretation of ABG's require formulaic manipulation and therefore accurate ABG values. Studies show ED people love venous ABG, internists prefer ABG. I am an old lab director and had previous lives in the clinic, before hospital medicine, and I love this stuff! The chemistry actually measures the total venous C02 , ( why we call it the C02; a confusing name ) and it should always be 2 to 3 points higher than the blood gas bicarbonate, ( because it's the bicarbonate plus dissolved C02 ), if your lab systems are working right. A quick way to check! Cheers!
Hey thanks for checking it out and for the kind words! We have been doing a ton of COVID-related content lately, but eventually will get back to general medical education. We are still trying to pepper a few non-COVID videos in here and there. Let us know if there are any other topics you feel would be of particular interest to turn into video form
@@WhiteboardMedicine I skimmed thru ur upload history and I couldn't find anything about hyponatremia. I think a video that goes thru the general algorithm for workup of hypoNa would be super helpful, especially with interpretation of urine lytes (with example numbers)...that always confuses me
@@nedrog Absolutely! Great topic. We were a relatively new channel (made the channel but were inactive for awhile before really putting out content) when COVID took control. Our non-covid content then really pittered off. We will add hyponatremia to the list!
Your A&P reviews, especially dealing with O2 /CO2 consumption & pH at cellular, level are so helpful. We SHOULD review what we too often forget & ignore, when we’re caught up in using new tech. We need to consider the basics- keeping in mind O2/CO2, Acid/Base balance and LIFE SUPPORT. That’s good medicine . Yes, doing more hemodynamic lectures would be great. How about a lecture addressing patient symptoms, what we can expect to see, when patients go down-hill fast, both with O2 deprivation & early signs of hemo -shock. _God I hated sticking new patients for ABG, before a central line was in_ Ouch
Let us know what you think about this whole Premier thing! We are just starting to figure it out. Don't see many downsides to it and thought it may be fun for viewers/WBDR community/us
Where can you get this test done? In Columbia, South Carolina and a friend desperately needs it. We’re calling all around and nobody does this test. Please help!
***Join our WhiteBoard Doctor Newsletter sent out on the 1st/15th of each month starting May 1st!!!****
Sign up at the link below:
whiteboarddoctor.m-pages.com/IAdAdI/wbdr-sign-up
Thank! Well done as usual. We do not measure the bicarbonate on the blood gas; the pH, the PC02, are measured and HCO3 is calculated by the Henderson Hassalbach equation. The venous oxygen is a source of great error...for a while in my shop the lab had actually started to use chemistry tubes for venous gas collection. That doesn't change the acid base much, or the PCO2; but gives you oxygen values that are higher than arterial?! Nobody but me complained about this. But we found the error and now they use the proper blood gas syringes.
Using the SVO2 from even a good central line has some problems, compared to a mixed venous ABG from the pulmonary artery of a Swan Ganz. I tell my COVid patients to expect one stick a day in the wrist, so I can follow their oxygen, (A-a ) gradient, etc; High flow you can use saturations, FI02's, and the ROX score. Sicker ones need an arterial line. Also lots of the arcane methods of interpretation of ABG's require formulaic manipulation and therefore accurate ABG values. Studies show ED people love venous ABG, internists prefer ABG. I am an old lab director and had previous lives in the clinic, before hospital medicine, and I love this stuff! The chemistry actually measures the total venous C02 , ( why we call it the C02; a confusing name ) and it should always be 2 to 3 points higher than the blood gas bicarbonate, ( because it's the bicarbonate plus dissolved C02 ), if your lab systems are working right. A quick way to check! Cheers!
Thanks for the excellent additions to the video! Great insights!
Yes. Do a lecture on Svo2
Will absolutely add it to the list!
this was great. they actually dont teach us much about VBGs in med school!!
Hey thanks for checking it out and for the kind words! We have been doing a ton of COVID-related content lately, but eventually will get back to general medical education. We are still trying to pepper a few non-COVID videos in here and there. Let us know if there are any other topics you feel would be of particular interest to turn into video form
@@WhiteboardMedicine I skimmed thru ur upload history and I couldn't find anything about hyponatremia. I think a video that goes thru the general algorithm for workup of hypoNa would be super helpful, especially with interpretation of urine lytes (with example numbers)...that always confuses me
@@nedrog Absolutely! Great topic. We were a relatively new channel (made the channel but were inactive for awhile before really putting out content) when COVID took control. Our non-covid content then really pittered off. We will add hyponatremia to the list!
thank you DR
Our pleasure! Thanks for checking out the video!
Your A&P reviews, especially dealing with O2 /CO2 consumption & pH at cellular, level are so helpful.
We SHOULD review what we too often forget & ignore, when we’re caught up in using new tech. We need to consider the basics- keeping in mind O2/CO2, Acid/Base balance and LIFE SUPPORT. That’s good medicine .
Yes, doing more hemodynamic lectures would be great. How about a lecture addressing patient symptoms, what we can expect to see, when patients go down-hill fast, both with O2 deprivation & early signs of hemo -shock.
_God I hated sticking new patients for ABG, before a central line was in_ Ouch
Those sound like excellent topics! Poking that artery is never a pleasant patient experience!
Pe e wls
SKKS S
Watch this video at1.5 speed and thank me later
What's the normal values for VBG?
80-110 mg/dl
Oh yeah! You’ve been busy. Look forward to the Series, esp. , Asymptotics, Evidence & Biases. AND the hottest topic (I think) Efficacy of masks!
Let us know what you think about this whole Premier thing! We are just starting to figure it out. Don't see many downsides to it and thought it may be fun for viewers/WBDR community/us
Where can you get this test done? In Columbia, South Carolina and a friend desperately needs it. We’re calling all around and nobody does this test. Please help!
Maximillia Harbors
Thanks for a great video!
Our pleasure! Thanks for checking it out!
Nice work
Thanks for checking out the video and for the kind words!
Oberbrunner Parks
Shields Parkways
Wuckert View
End soe w woee 😊
E lew