A child is taken to the emergency department with severe dyspnea. A blood gas reveals the following values: pH = 7.45; PaCO₂ = 35; HCO₃^- = 23; PaO₂ = 63; SaO₂ = 90%. What is the most appropriate initial therapy?

Question

Quizplus · Accepted Answer

The blood gas values indicate respiratory alkalosis with a slightly elevated PaCO2 and normal bicarbonate levels. This suggests that the child is hyperventilating, possibly due to anxiety, pain, or infection. Administering oxygen can help relieve the dyspnea and correct the hypoxemia without worsening the alkalosis. Administering sodium bicarbonate would further increase the pH and may exacerbate the hypoxemia by decreasing the partial pressure of oxygen in the blood. Having the child rebreathe into a paper bag could relieve the dyspnea but may worsen the alkalosis by increasing carbon dioxide levels. Doing nothing is not appropriate as the child is in distress and needs immediate intervention.

A Child Is Taken to the Emergency Department with Severe