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NNH Clinical Protocol

NNH Acid-Base Diagnostic Pilot

A provider-facing tool for systematic acid-base interpretation, compensation analysis, mixed disorder detection, and diagnostic next steps.

Developed by Craig G. Hurwitz, MD

📚 Physiologic approach (Berend, NEJM 2014)📄 Rules of engagement (Adrogué/Madias, JASN 2010)⚠️ For NNH clinical staff — decision support only
Step 1

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[One sentence guiding the clinician on what they're choosing.]

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Recommendation

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Choose a different procedure
Clinical decision support, not a substitute for clinical judgment. This pilot is designed to support clinical reasoning, not replace it. Always integrate results with the clinical picture, hemodynamics, ventilation status, and bedside assessment. Verify allergies, drug interactions, and renal/hepatic dose adjustments before administration. [Replace this sentence with protocol-appropriate caveats about evidence quality, regulatory grade, or guideline limitations.]

Reference

Berend K, de Vries APJ, Gans ROB. Physiological approach to assessment of acid-base disturbances. N Engl J Med 2014;371(15):1434-1445. doi:10.1056/NEJMra1003327

Adrogué HJ, Madias NE. Secondary responses to altered acid-base status: the rules of engagement. J Am Soc Nephrol 2010;21(6):920-923. doi:10.1681/ASN.2009121211

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