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So what was going on with her?
65 year old female
- Thread starter NomadicMedic
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OP
OP
NomadicMedic
I know a guy who knows a guy.
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the doc said said she was septic and had an MI. I gave her fluid and Zofran to treat her symptoms. In the last few minutes of transport she started to be come confused. Coded in the ED, worked for 45 minutes and pronounced.
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What did you call that EKG?
OP
OP
NomadicMedic
I know a guy who knows a guy.
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New onset LBBB. She had no history.
E tank
Caution: Paralyzing Agent
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echo would tell a lot...PE is the go to dx short of anything else....
T1medic
Forum Crew Member
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Hyperkalemia would be my guess. The previous day prep along with the current diarrhea plus the stomach bile leads me towards this.
I may completely off here but id say that 12 lead is also indicative of hyper k+. Wide complex tachycardia yet not fast enough to be v-tach (see Amal Mattu).
Most people tunnel to the "peaked t-waves" for hyper k+ but the v-tach mimic is seen when serum potassium levels get to the 8-9 mEq/L levels.
This could explain why she arrested.
My teatment would be A-B-C-D Albuterol, Bicarb, Calcium, Diuretic (Lasix). Would start with the bicarb and calcium first.
Like I said. I could be way off, just my random thoughts.
I may completely off here but id say that 12 lead is also indicative of hyper k+. Wide complex tachycardia yet not fast enough to be v-tach (see Amal Mattu).
Most people tunnel to the "peaked t-waves" for hyper k+ but the v-tach mimic is seen when serum potassium levels get to the 8-9 mEq/L levels.
This could explain why she arrested.
My teatment would be A-B-C-D Albuterol, Bicarb, Calcium, Diuretic (Lasix). Would start with the bicarb and calcium first.
Like I said. I could be way off, just my random thoughts.
While your management for hyperkalemia is correct, the inference of diarrhea and vomiting leading to hyperkalemia is not. Volume losses from the GI tract, i.e. vomiting and diarrhea, lead to hypokalemia -- not hyperkalemia.
VFlutter
Flight Nurse
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Whatever it is....blame Anesthesia
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You would never believe how true that actually is.Whatever it is....blame Anesthesia