Appendicitis.... Cardiac issue

Sandiistaken123

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So this is a wild one a few sma changes for patient privacy.

14 y/o female cc of ABD pain

ABC: airway clear and protecting, breathing effort normal with no difficulty, circulation okay on appearance and mental status= A&O x 4

Sample:
ABD pain, specifically RLQ, sharp, w/ hip radiation
Allergic to penicillin based medication

Daily aspirin (doctor recommended)

History of unknown arrhythmias (parents didn't remember the name)

Last oral intake was a sandwich

Events leading was just reading a book

Original vitals:
HR 115 (sinus) BP 168/91 O2 92% RR 12 BGL 140 and temp 98.7f

ECG preformed due to cardiac history which was normal sinus tachycardia

Mc Burney point positive

Transport started for possible appendicitis heading to a children's hospital less then 10min

Breathing sounded clear so started on 3lpm NC

Then medic told me to pull over and stop moving then I heard him use his side radio "patient CPR in progress" and he yelled drive so I started driving faster and I heard the lotus CPR machine and we arrived then the medic went in I parked and went in and medic was giving report while the room was full of people. We left shortly after and CPR was still in progress. Any ideas?
Why are people saying “ectopic”? How do we know this isn’t just an appendicitis?

I’m an EMT student so I would appreciate explanations ❤️
 

DesertMedic66

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Why are people saying “ectopic”? How do we know this isn’t just an appendicitis?

I’m an EMT student so I would appreciate explanations ❤️
It’s a differential diagnosis. It could be appendicitis or it could be an ectopic pregnancy. However appendicitis will rarely lead to a sudden arrest like this patient had and is more often seen with a ruptured ectopic pregnancy.
Oh wow, was there internal bleeding?
Yes, a ruptured hepatic artery will cause internal bleeding just like any ruptured artery
 

Sandiistaken123

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It’s a differential diagnosis. It could be appendicitis or it could be an ectopic pregnancy. However appendicitis will rarely lead to a sudden arrest like this patient had and is more often seen with a ruptured ectopic pregnancy.

Yes, a ruptured hepatic artery will cause internal bleeding just like any ruptured artery
what you're saying is that appendicitis is gradual?
Makes sense, in 2022 I went to the ER for sudden severe pain in my RLQ thinking it was appendicitis, however it was a ruptured cyst.
 
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