Reza

To bring out the tension is unreal.

It's also so cool to see how savvy the clinicians were because the number of times you rush to send an ABG in a situation like this is not as much as you think because you trust the oxygen saturation.

And you don't really need an ABG in a situation of rapid response.

You might get that in the ICU when the dust has settled to really understand where you're at.

So really cool to see the instinct of the folks.

And so I retract everything I said about put back that oxygen now, you know.

There is, however, one important fake out for us to know.

which is how can the PaO2 be false and mislead us?

And I actually had a case of this in residency.

And it was an oncology ward.

It was a patient with acute leukemia.

And the leukemic cells, actually, when they sit in the ABG analyzer on the way to the lab, they consume all the oxygen.

So it's a cause of a falsely low PaO2, not because the patient has a low PaO2, but rather they have hypercellularity that causes the potassium to go up when they break down, but also chews up the oxygen.

But in that situation, the SAO2 should be normal.

So there's no reason to doubt that here.

And so I believe this patient really has true hypoxemia.

And I think you're seeing one really fundamental fact, and that's the disconnect between

that you outline all the time, Prof Rez, of dyspnea and hypoxia are the very, very different problems.

When somebody has shortness of breath, we know that the differential diagnosis ranges much more than patients who have hypoxemia.

So for example, you can get a shorter breath with ACS with no otocyte issues.