shelvpower
Forum Crew Member
- 78
- 10
- 8
Hi there.
I would appreciate some advise/ inputs on the possible causes of the following pt's ECG.
We were on our way to do a transfer when we came across a pedestrian that was struck by a lmv on the highway.
O/A the patient (approximately 25years old) was lying supine on the road with a GCS of 9/15 (E5V2M2). Patient presented with epistaxis as well as otorrhagia. The only injury that was found was a deep laceration to the patient's occipital lobe with +-1L of blood lying next to the pt on the road.
Due to the patient being highly combative/restless a decision was made to sedate the pt with Midazolam IMI.
After sedation the patient's wound was bandaged, IV access as well as a set of vitals were obtained.
Initial vitals were as follows:
HR 90
SATS 85% on RA
BP 95/60
HGT 6.7mmol/L
RR 15BPM (clear and equal air entry)
The pt also presented with pinpoint pupils.
The patient was placed on a 60% O2 mask which improved his SATS to 98%. The patient's BP increased to 110/75 after a 200ml fluid bolus. A choice was made not to intubate this patient due to him still maintaining his own airway and also due to us being 5 minutes away from a level 1 facility.
The part of this call that confused me was when we did a routine ECG en route to hospital and found some abnormalities.
Attached is a copy of the pt's ECG (unfortunately no 12 lead photo). Any inputs as to what can possibly cause these changes in a TBI patient will be highly appreciated.
Regards
S
Sent from my SM-G930F using Tapatalk
I would appreciate some advise/ inputs on the possible causes of the following pt's ECG.
We were on our way to do a transfer when we came across a pedestrian that was struck by a lmv on the highway.
O/A the patient (approximately 25years old) was lying supine on the road with a GCS of 9/15 (E5V2M2). Patient presented with epistaxis as well as otorrhagia. The only injury that was found was a deep laceration to the patient's occipital lobe with +-1L of blood lying next to the pt on the road.
Due to the patient being highly combative/restless a decision was made to sedate the pt with Midazolam IMI.
After sedation the patient's wound was bandaged, IV access as well as a set of vitals were obtained.
Initial vitals were as follows:
HR 90
SATS 85% on RA
BP 95/60
HGT 6.7mmol/L
RR 15BPM (clear and equal air entry)
The pt also presented with pinpoint pupils.
The patient was placed on a 60% O2 mask which improved his SATS to 98%. The patient's BP increased to 110/75 after a 200ml fluid bolus. A choice was made not to intubate this patient due to him still maintaining his own airway and also due to us being 5 minutes away from a level 1 facility.
The part of this call that confused me was when we did a routine ECG en route to hospital and found some abnormalities.
Attached is a copy of the pt's ECG (unfortunately no 12 lead photo). Any inputs as to what can possibly cause these changes in a TBI patient will be highly appreciated.
Regards
S
Sent from my SM-G930F using Tapatalk
