The fastest physiological mechanism for acid base correction is a) bicarbonate buffer system b) phosphate buffer system c) renal system d) respiratory system a) bicarbonate buffer system pH calculation of the presence of H Test tip: Hydrogen (H⁺) -> Acid During aerobic metabolism cells primarily produce Adenosine triphosphate Bohr Effect occurs as a result of CO₂ binding to HgB causing decreased affinity of hemoglibin for oxygen Test Tip: Bohr effect -> release of O₂ -> tissue level Most definitive test for 'shock" Elevated lactate normal lactate is 0.7-2.1 mEq/L (remember Lactate 1-2) Test tip: Shock -> Lactate Lactate>4 ->significant acidosis -> hyperkalemia Oxyhemoglobin dissociation curve Right shift: HbG Releases O₂ Right shift caused by; Raised temp; Raised 2-3 DPG; Raised acidosis; Reduced oxygenation Oxyhemoglobin dissociation curve Left shift HgB hoLds O₂ Left shift caused by: Low temp; Low 2-3 DPG; aLkalosis (Low acidosis); Lots of CO "Fixed acids" are removed by Renal system only Cannot be be changed by the bicarbonate buffer system Haldane effect is what emables us to remove large amounts of CO₂ Magority of CO₂ is transported by bicarbonate in plasma The relationship of EtCO₂ to PaCO₂ should demonstrate EtCO₂ is slightly lower than PaCO₂ this pressure gradient is what allows CO₂ to be removed from lungs The relationship of pH, K+, EtCO₂ and PaCO₂ ^PaCO₂ 10mm Hg -> _V pH 0.08 (for every change of PaCO₂ 10mmHg you will see a change of pH 0.08 in opposite direction) ^ pH 0.1 -> _V K+ 0.6 (for every change of pH 0.1 you will see a change of K+ 0.^ in opposite direction) Change in EtCO₂ is about = to change in PaCO₂