IBSC Certified Critical Care Paramedic (CCP-C) Practice Test

After evaluating pH, PaCO2, and HCO3-, what is the next step in ABG interpretation?

Determine compensation Assess oxygenation Assess lactate Calculate base deficit

Correct Answer:

Calculate base deficit

Explanation:

After you’ve looked at pH, PaCO2, and HCO3- and identified whether the disturbance is metabolic or respiratory and whether there’s appropriate compensation, you quantify the metabolic component with a base deficit. The base deficit reflects how much buffering is needed to restore normal pH at the current PaCO2, essentially measuring the metabolic acid load the patient is carrying. A more negative base deficit means a greater metabolic acidosis and often correlates with tissue hypoperfusion or lactic acidosis, guiding you on severity and treatment response. Lactate can provide additional context, but the base deficit gives a direct, calculated measure of the metabolic component from the ABG data itself, making it the logical next step to quantify metabolic derangement.

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