Blood Gas # 29

Posted Leave a commentPosted in ed, medical

History: A 39 year old highly functioning professional female is brought to ED complaining of abdominal pain and nausea.  She has a VBG performed. pH 7.29 Na 138 mmol/L pCO2 28 K 1.4 mmol/L pO2 51 Cl 111 mmol/L HCO3 14 Creatinine 126 mmol/L Glucose 5.7 mmol/L Lactate 1.6 mmol/L Her baseline creatinine was 62 three months ago.

Staggered Paracetamol Overdose

Posted Leave a commentPosted in ed, education, toxicology

STEM: A 16yr old female presented to the emergency department at 0100 after taking an overdose of paracetamol.  She is normally fit and well with no past medical history.  She is alert and looks well, with normal vital signs.  She has taken standard immediate-release paracetamol – 40x500mg at 1930 and 20x500mg at 2200. [expand title = “RESUSCITATION”] A / B / C […]

Blood Gas # 28

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History: A 42yr female was brought to ED as a priority 1 trauma after she was found on the floor at home.  History of alcohol abuse drinking at least 2 bottles of wine per day.  GCS12 (E3 V4 M5), confused.  Bilateral raccoon eyes. pH 7.59 Na 105 mmol/L pCO2 45 K 2.6 mmol/L pO2 50 Cl 49 mmol/L HCO3 43 […]

Blood Gas # 27

Posted Leave a commentPosted in ed, education

History: An obese 57yr male presented with a deliberate self-harm attempt of 5 days’ worth of his blister pack medications at 10pm.= Total doses ingested shown below: Perindopril 20mg Metformin 15g Allopurinol 1500mg Sodium Valproate 10g Zopiclone 37.5mg Thyroxine 250mcg Aspirin 500mg Lorazepam 5mg Gliclazide 300mg Rosuvastatin 200mg Quetipaine 250mg Sitagliptin 500mg Ferrous sulphate (elemental iron 105mg per tab) 525mg […]

Blood Gas # 26

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History: A 64 year old male was brought in by ambulance after his friend called them.  He was unconscious in the park, is a known IV drug user and has had recurrent ED presentations with drug intoxication.  He was intubated for a GCS 7. Here is his ARTERIAL blood gas: pH 7.09 Na 142 mmol/L pCO2 99 mmHg K 4.7 […]

Blood Gas #25

Posted Leave a commentPosted in ed, education

History: A 45yr alcoholic female with epilepsy, previous traumatic head injury and T2DM presented to ED following a syncopal episode and a fall onto her face. PMH: depression, PTSD and agoraphobia.  On sertraline and carbamazepine. pH 7.55 Na 130 mmol/L pCO2 58 mmHg K 2.5 mmol/L pO2 35 mmHg Cl 58 mmol/L HCO3 51 mmol/L Glucose 6.1 mmol/L Lactate 1.0 […]