We review the FOAM from SMACC GOLD), Dr. David Story's "Is Chloride A Poison)?" for a great primer on the Stewart method to acid-base. The Strong Ion Difference (SID) is essentially Sodium minus Chloride (Na - Cl). Normal = 38; a higher SID indicates metabolic alkalosis and a lower SID indicates a metabolic acidosis. "Normal Saline" has a whopping amount of chloride, which decreases the SID and has been associated with acidosis, renal insufficiency in critically ill patients, and, perhaps, mortality.*
As always, visit foamcast.org) for show notes and the generously donated Rosh Review questions.*
Key Texts: Tintinalli (7e) Chapters 19,21 ; Rosen's (8e) Chapters 124, 125*
FOAM Resources: Acid-Base ala EMCrit I)/II)/III)/IV), Hyponatremia - EMBasic), Hyponatremia-ERCast), Hyponatremia - EMCrit)*
Thanks y'all!*
-Jeremy Faust and Lauren Westafer*
