Acid-Base Diagnosis & Clinical Approach with Dr. Bill Bortcosh--Part 1

Oct 28, 2024

Dr. Bill Bortcosh, a pediatric critical care expert and associate medical director of safety, shares insights into acid-base diagnosis in this engaging discussion. He emphasizes the importance of understanding acid-base status for acute care, illustrates this with a compelling case study, and explains the role of anion gap in diagnosis. Bortcosh also explores the emotional challenges in critical care and discusses his transition to pharmaceutical safety, shedding light on drug safety assessments and the complexities faced by healthcare providers.

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Episode notes

Intro

00:00 • 2min

Transitioning from Clinical Practice to Pharmaceutical Safety

02:12 • 2min

Navigating the Challenges of Critical Care and Acid-Base Physiology

04:21 • 3min

Exploring Acid-Base Diagnosis Through Case Study

07:15 • 2min

Understanding Acid-Base Balance in the ICU

08:51 • 18min

Understanding Anion Gap in Clinical Diagnostics

26:57 • 7min

Dr. Bill Bortcosh received his Doctorate of Medicine from Albany Medical School, NY. He completed his pediatric residency at the University of Massachusetts Medical School followed by pediatric critical care fellowship at Massachusetts General Hospital.
Learning Objectives:

By the end of this podcast series, listeners should be able to discuss:

Why critical evaluation of a patient’s acid-base status can be useful and practical in the acute care setting
The basic pathophysiology of each acid-base disturbance
The definition of an anion gap and how to use it as a screening tool
The use of Winter’s formula to identify a respiratory acidosis or alkalosis
The utility of the delta-delta to identify additional metabolic acidosis or alkalosis

Link to Acid/Base Handout

References

1. Carmody JB, Norwood VF. A clinical approach to paediatric acid-base disorders. Postgrad Med J. 2012;88(1037):143-51.

2. Carmody JB, Norwood VF. Paediatric acid-base disorders: A case-based review of procedures and pitfalls. Paediatr Child Health. 2013;18(1):29-32.

3. Emmett M. Approach to the Patient With a Negative Anion Gap. Am J Kidney Dis. 2016;67(1):143-50.

4. Luke RG, Galla JH. It is chloride depletion alkalosis, not contraction alkalosis. J Am Soc Nephrol. 2012;23(2):204-7.

5. https://emcrit.org/ibcc/salicylates/

Citation: Bortcosh W, Shanklin A, Hodges Z. Acid-Base Diagnosis & Clinical Approach. PedsCrit Online Podcast. 10/2024. https://www.pedscrit.com/acid-base-diagnosis-clinical-approach-with-dr-bill-bortcosh-part-1/

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Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.