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What's in a Blood Gas? VBG vs ABG
Diagnostics, Grand Rounds Jeffery Hill, MD M.Ed Diagnostics, Grand Rounds Jeffery Hill, MD M.Ed

What's in a Blood Gas? VBG vs ABG

You’re deep into a busy shift. Pushing yourself to see more volume towards the end of the year, you find yourself actively managing 8 patients.  You have 2 patients with difficulty breathing you believe have COPD exacerbations and 1 patient with a history of T1DM who has a critical high finger stick blood sugar and ketones in their urine.  You send VBGs as part of the work up for all these patients finding hypercarbia for the patients who have COPD exacerbations and a significant metabolic acidosis in the patient with T1DM confirming your diagnosis of DKA. You are in the process of admitting these patients when you face questions from your colleagues in-house as to why you didn’t perform an ABG on these patients?

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EKG Toxicology
Diagnostics, Grand Rounds Jeffery Hill, MD M.Ed Diagnostics, Grand Rounds Jeffery Hill, MD M.Ed

EKG Toxicology

Emergency medicine physicians frequently assess and treat patients who have accidental or intentional poisonings. United States poison centers receive over two million case referrals per year. And, about 20% of these poisonings present to an Emergency Department for evaluation. Evaluation of these patients always includes a history and physical, but further testing can provide valuable information. Blood work is often be needed, but an EKG is a faster, cheaper tool that can provide key pieces of information prompting early interventions. 

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