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.
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 […]
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 […]
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 […]
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 […]
STEM: A 26 year old male presented to ED at 0730 with abdominal pain and vomiting. He took 100 tablets of 500mg paracetamol at 2230 the night before. He is normally fit and well, drinks regular alcohol and uses meth on most days. He is alert and orientated. [expand title=”RESUSCITATION”] A – B – C – : no acute […]
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 […]