A 23-year-old woman with a history of asthma was brought to the emergency department by ambulance. She was extremely short of breath. Her level of consciousness was diminished greatly, and she was only able to respond to questions with nods or one-word responses. She had a weak cough, with nearly inaudible breath sounds. After drawing blood gases, she was placed on supplemental oxygen. Vital signs: heart rate, 160 bpm; blood pressure, 120/84 mm Hg; temperature, 37°C; and respiratory rate, 36/min. Her initial blood gas and total hemoglobin results were as follows: pH = 7.330 pCO2 = 25 mm Hg pO2 = 58 mm Hg HCO3 = 13 mmol/L tHb = 12.4 g/L QUESTIONS: 1. What is the patient’s acid-base and oxygenation status? 2. What is the cause of the acid-base disturbance? 3. Does asthma typically present in this matter? 4. What clinical findings are most indicative of this patient’s impending failure?

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A 23-year-old woman with a history of asthma was brought to the emergency department by ambulance. She was extremely short of breath. Her level of consciousness was diminished greatly, and she was only able to respond to questions with nods or one-word responses. She had a weak cough, with nearly inaudible breath sounds. After drawing blood gases, she was placed on supplemental oxygen. Vital signs: heart rate, 160 bpm; blood pressure, 120/84 mm Hg; temperature, 37°C; and respiratory rate, 36/min. Her initial blood gas and total hemoglobin results were as follows: pH = 7.330 pCO2 = 25 mm Hg pO2 = 58 mm Hg HCO3 = 13 mmol/L tHb = 12.4 g/L QUESTIONS: 1. What is the patient’s acid-base and oxygenation status? 2. What is the cause of the acid-base disturbance? 3. Does asthma typically present in this matter? 4. What clinical findings are most indicative of this patient’s impending failure?
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