The BMP Deep Dive: Eight Numbers That Tell You More Than You Think
The BMP Deep Dive: Eight Numbers That Tell You More Than You Think Sodium algorithms, the anion gap you should be calculating on every panel, and why creatinine lies about half the time. The basic metabolic panel is the most ordered lab in outpatient and inpatient medicine. Eight values: sodium, potassium, chloride, CO2 (bicarbonate), BUN, creatinine, glucose, and calcium. Most clinicians glance at the sodium and creatinine and move on. But buried in those eight numbers are patterns that diagnose DKA, renal failure, toxic ingestions, adrenal crises, and metabolic emergencies—if you know how to read them. The Anion Gap: Calculate It Every Single Time Anion Gap = Na − (Cl + CO2) Normal: 4–12 mEq/L. This should be calculated on every BMP. An elevated anion gap means unmeasured acids are accumulating in the blood, and many of the causes are immediately life-threatening. High Anion Gap Metabolic Acidosis (HAGMA) The classic mnemonic is CAT MUDPILES : C yanide, CO poi...