FOAMfrat Podcast

Welcome to the third installment of this metabolic panel series, where we're exploring what happens when these lab values hit their limits, or beyond. Previously we've explored Cations (located here) and Anions (located here), but don't feel like you need to read these in any particular order.

These blogs are meant as a reference for you to come back to. There's a lot of information in each, so they might be better absorbed in chunks. I'm writing these as the reference I wish I had when I started learning lab values.

This week we're going to tackle the renal values on our chemistry panel! Renal physiology can be more than a little intimidating, but you're going to totally understand these labs by the time we're done! Because this renal section is a little different than the other sections, I'm going to start us off with a little refresher on the nephron, using a couple of illustrations.

What does jaundiced skin, right upper quadrant pain, and a fever mean? In this episode, Dr. Cynthia Griffin and I discuss everything gallbladder and biliary colic! Check out the blog post here:

https://www.foamfratblog.com/post/when-gall-bladders-attack

Welcome to the second installment of this metabolic panel series, where we're exploring what happens when various lab values reach their outer limits (or beyond). Each part in the series can be read on its own, but if you want to start at the beginning, go check out the first blog on cations HERE.

This series of blogs and podcasts are meant as a reference for you to come back to. There is a lot of information on each one of the lab values we'll cover, so it might be best to read it in parts. As I mentioned in the last blog, I'm writing these as the reference that I wish I had when I started learning to interpret lab values.

In this portion of the series we'll be discussing anions - the negative changes in the serum. We'll be starting off with chloride, which accounts for the majority of the negative charge in our blood!

In this episode, Sam and I discuss warfarin's mechanism of action and reversal. Check out the blog for more information!

https://www.foamfratblog.com/post/podcast-132-reversal-rehearsal-warfarin

Lab value interpretation sadly wasn't included in my initial paramedic education. I was absolutely ecstatic to attend a critical care program and learn about lab values - I had always found it very impressive when people could interpret lab values. I wanted to be a lab value wizard too! Unfortunately, in critical care class, our lectures and resources were nothing like what I had hoped for.I hope this series of blogs serve as a resource for those who are eager to learn more about the art of interpreting labs. I wouldn't recommend tackling this whole thing in one sitting ;) We'll be starting with the positive charges (cations) in this blog, then handling the other parts of the basic metabolic panel in weeks to come (negative charges, renal, and glucose).

Before we get started, I want to get us in the right headspace for learning about lab values. This stuff is kind of dense, and there are a lot of different conditions that will cause lab values to reach their outer limits, or beyond. While I'll present a lot of information for each lab value abnormality, the theory of what's going on is far more important. Once you understand the theory of why a problem occurs, you can find a formula, calculator, or treatment guideline to get you the rest of the way.

Now let's what happens when cations reach their outer limits!

Welcome to round two! We'll be going over fewer laws than last time, but this will round things out nicely! We'll be covering the laws of Fick, Graham, and Dalton/Amagat. Mike Brown joins me again as we look at the clinical application of some lesser-known gas laws.

• Do not delay transport to PCI to grab a right-sided ECG.
• If you do decide to perform a right-sided ECG, it should not be for the decision on whether or not to give nitro.
• If time permits, it may be helpful and confirm your suspicions of RV involvement.
• Isolates RV infarcts are extremely rare.

We've been exposed to gas laws our whole life, and we have intuition about what will happen to gas under certain conditions. For example, people notice that the pressure in their tires might become low on a very cold day. Or perhaps you've been at very high altitudes and you've been short of breath. And everyone knows that if you shake a carbonated beverage before opening it you'll be cleaning up a mess very shortly. Each of these observations has been classified into the laws, and we'll be splitting them up between this blog and the next. Stating the laws is one thing - anyone with google can copy and paste their definitions. However, we have a special interest in these laws as medical professionals because we deal with them on a different level. Sometimes we're manipulating these gas laws on purpose, and other times we're dealing with their side effects. Or perhaps we're just trying to pass our FP-C, CCP-C, or CFRN exam ;)

Let's dive (pun intended) right in!