Respiratory Therapy student here, this is helpful for my ABG quiz today. Thanks so much!

Thanks Dr. Roger Seheult! very well explained and I loved the fact that you added cases at the end. Thanks.

I'm following this series of videos and the number of views goes from over 300 k for the first video to barely over 100 k in this 7th video. Only the strong ones here! Hahaha. But seriously, this have been a ride! I've never understood this so clearly, thank you!

Man, this is so amazing. I did not truly understand the utility of delta gap and Winter's rules before this. Amazing.

This was the hard part - to understand the additional respiratory process that goes on with the metabolic process. Thank you for explaining it so well that anybody can understand. I cannot thank you enough for this lecture. Thank you.

@skyview071

3 жыл бұрын

i

This video series has helped me out beyond words. Thank you so much Dr. Seheult!

@anaghanagarale6979

4 жыл бұрын

Did u get the 8th part?

thank you dr... it really helps me a lot! everything well explained.

This helps us a lot. Thank you Doctor.

thank you so so much! I spent years at nursing school not understanding fully. If teachers played your videos, I would have undesrstood on first try!!

Hi,Thanks for clear explanation and principle to use.

Great! That's what this is all about - making the medical world make sense one topic at a time.

Acid base disorder very clear now many thanks to u. One more lecture to go!

Very clear presentation....

Thank you very much.

Finally I get it! thanks!

Thank you very much

Thank you ,understood after four repeats

Yeah you're right, I went on to study it some more and realised you use the base excess (normal range -2 to +2) to determine wether there is a metabolic component to the pH, ie. renal compensation or metabolic alkalosis/acidosis through HCO3. By the way I had my exam in acute medicine yesterday and was presented with 5 different abg's and everything went smooth. Got a B, I didn't get an A because I missed something on an X-ray hehe. So thanks again for the videos, I appreciate them. :)

thanks alot

You are awesome, you should consider partnering with a rph who is just as knowledgeable in their field and understands the needs for naplex. This way we get both the med side and in depth pharm side. Although you do provide some info its not as in depth as we need.

This is the most helpful video about ABG I've ever watched. Though I think the 3rd example was wrong in application of Winters formula. Maybe a review would do wonders. Thanks anyway.

Hi, could you explain how you were able to tell in the first example that the additional bicarb was due to metabolic acidosis and not renal compensation?

For the first example in this video, why does the Winturn's formula hold for AG Met Acidosis? Shouldn't the pC02 be higher since it has to compensate for Met Alkalosis as well?

Damn. I finally understand this crap. Its still complicated but systematic approach helps to organize thoughts when solving these numbers. Thank you soooo much. My next issue is ECG. Will definitely buy the course. This guy kicks ass!!!

@Medcram

6 жыл бұрын

+V.A. Thanks. I think you will like the EKG course.

Thanks for explaining. Was a little hard to understand for me at first, since we get the abg listed with different units here (kiloPascale and mmol/L) and also we get the base excess listed, which I guess is equivalent to the anion gap. .

Hi. Thanks for the explanation, helps a lot! When calculating the delta anion gap, do we always use the number 12 for predicted anion gap, or should we count using albumin multiple by 3 instead? Thank you!

Would it be correct ( or more appropriate ) to say in the first example that you have a AG metabolic AcidEMIA and a metabolic AlkalOSIS?

Final example: will we ever need to differentiate between acute and chronic if the resp disorder is the 2nd concomitant problem?

I've been using the formula pCO2 = (1.5 x HCO3) + 8 for Winter's formula to find the expected pCO2 b/c I can calculate this faster than comparing the ratio of the delta HCO3 and delta pCO2. Does this work in all cases (never breaks down)?

12:28 what is the difference here between using the formula pCO2 = 1.5 x HCO3 + 8 and doing your method? I am curious because it seems the formula above suggests there would be a concomitant resp alkalosis with the met alkalosis, but that is not the conclusion you reached? So are both answers possibly correct? (as your fraction was also not as close as usual..)

Dear sir, Thank you and your team very much for all sharing these medical lectures. I could not find part 8 ! How could i have it please?

@Medcram

5 жыл бұрын

Thank you! Part 8 is free at MedCram.com: www.medcram.com/courses/medical-acid-base-explained-clearly

@Borin66669

5 жыл бұрын

Great, thanks a lot from Cambodia 🇰🇭

@Medcram

5 жыл бұрын

+Borin បូរិន្ទ go to Medcram.com

@7:34 - At what point would this shortcut break down? In this case, we assumed that 12/13 is close enough to 1/1, but exactly where can we draw that line? 12/14 is pretty close too but as we get further and further away, 12/15, 12/16, 12/17, where can we say that we are beginning to break away from a pure 1/1 ratio? In the Winter's formula, 1.5[HCO3]+8, there is a component of +/- 2 to account for this range. I like the method that you use but I need to be convinced that it won't miss any respiratory acid/base disturbances just because I assumed that the ratios were "close enough" to 1/1.

@mohdridhaabdullah4058

6 жыл бұрын

for me, it is met. acidosis with respi compensation...is it same with you?

I couldn't find the 8th part . could you plz share it with me?

@rodinaacharya4384

4 жыл бұрын

hey did you get the 8 part?

@tylerwood4723

4 жыл бұрын

kzread.info/dash/bejne/gXiawaaEls2od8Y.html Guess they made the video private. Bummer

@higginsba

4 жыл бұрын

Was looking for it as well ☹️

@higginsba

4 жыл бұрын

Found it on their webpage - www.medcram.com/courses/take/medical-acid-base-explained-clearly/lessons/4957060-practice-cases-part-3

Hi Thanks for your great lectures. Unfortunately the 8'th video is not available. I wonder why it's shown as a private video?

@Medcram

5 жыл бұрын

Glad you're enjoying the lectures. The 8th video is available free at our website www.MedCram.com This is where all of our videos and updates are located... the "updates" part is important because unfortunately, as things change in medicine, we aren't able to update/annotate our videos on this platform. Once videos are posted here, they are essentially static. We're also able to focus on creating new content by charging for some of our courses or for All-Access. Thank you for the comment. Please reach out to us at customers@medcram.com with any questions.

@khashayarnn

5 жыл бұрын

@@Medcram Thanks for your reply that was helpful.

there are several way of doing it. Another way is to simply at 15 to the bicarb and see what the CO2 is. if the actual co2 is higher then (bicarb + 15) you have a resp acidosis, if the actual co2 is lower then (bicarb + 15) you have a resp alkalosis. - works most of the time.

@tanyabhattacharjee5293

4 жыл бұрын

rdseheult Hi Dr Seheult, am not able to get access to 8th video of acid base. By the process of getting co2 in the above manner, how will I know if it is acute or chronic?

How did you determine in 16.28 that there is a respiratory acidosis when the rule for that is 1/3 or 1/2 when we have 9/0 ?

@ShayShayAmina

7 жыл бұрын

So from my understanding, the Dr. stated that because the response was inappropriate there are other processes occurring. So when you look at how much the HCO3 changed which was 9, you should expect the pCO2 to also change by 9, since it is a 1/1 for metabolic acidosis. When we notice this is not the trend, we have to look at what the CO2 did. In the end the CO2 did not go as low as expected, meaning there is some CO2 coming from somewhere else, meaning a respiratory acidosis is causing the extra CO2. Because it is a mixed process, the intial winter's formula will not work out as the responses are inappropriate because there are several processes occurring at the same time. The doctor basically tells us, when the expected compensation does not occur, the estimated Winter's rule will not apply and we need to look for additional processes causing the mixed acid/base issues in the body. So in all, the last question was triple mixed including: Anion gap metabolic acidosis, metabolic alkalosis, and respiratory acidosis.

how can we determine whether there is a concomitant metabolic alkalosis in non anion gap metabolic acidosis or not?

@Medcram

6 жыл бұрын

+Samar Esawy you can only tell the sum of their magnitudes. I. E. Which one is more prevalent.

@Medcram

6 жыл бұрын

+Samar Esawy this is done by adding the delta gap to the current bicarbonate. If substantially greater than 24 then alkalosis. If less than 24 then acidosis.

hi there thanks aot.. i have a patient of mine can help me ot for this confused with winters formula... 6.98/64.5/243/14.4 chem 7: 132/3.4/98/14.4 hope u can help thanks again

@Medcram

5 жыл бұрын

+ashish panthi looks like: 1) Anion Gap Metabolic Acidosis 2) Respiratory Acidosis Anion gap is 20. Delta gap is 8 (assuming albumin is 4). Therefore bicarbonate would be 22 if anion gap metabolic acidosis were gone meaning that there is no other metabolic issue or that if there is they are balanced. Given this the pCO2 should go down from 40 but instead it is actually above 40 meaning there is a Resp acidosis.

mecram for president of WHO actually no he would be too busy and neglect us and wouldnt make vids anymore :(

Sorry bout that!. Actually the base excess is not the anion gap but is related to the amount of HO3 in the serum. (i.e. 0 means normal).

What happened to the 8th video?

@Medcram

5 жыл бұрын

+Hannibal EnemyofRome go to Medcram.com

CRYSTAL CLEAR

Sir, we do not have chloride ion conc. In our abg report , we have base excess how to calculate anion gap

adjusted anion gap = anion gap + (2.5x[4-serum albumin]

Where is the eighth Video.......??????????

@Medcram

5 жыл бұрын

+seerat singh at MedCram.com

@seeratsingh7889

5 жыл бұрын

MedCram - Medical Lectures Explained CLEARLY thank you sir...