fast65
Doogie Howser FP-C
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Quick question for everybody. Have any of you ever seen a patient with Cushing's triad (HR: 35, BP: 180/P), but who still has a GCS of 15?
the 100% directionless thread
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foxfire
Forum Asst. Chief
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I have only seen true crushing triad once so far. and the pt was about 8 GCS.
fast65
Doogie Howser FP-C
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Well the weird thing was that I had a transfer last night for a young adult male that came into the ED complaining of a headache. After he vomited and became lethargic they decided to transport him to the level 1 hospital (from level 4). Upon arrival he was coherent and was arguing that he didn't need to go, his pulse was 50 which is normal for him.
During transport he started to go between a pretty noticeable sinus arrythmia into a junctional rhythm where he stayed for the rest of transport. His rate was down in the 30's or low 40's most of the time, but he showed no signs of poor perfusion. He kept complaining of his HA getting worse, after less than an hour we had given him 6 mg morphine and 1 mg versed, but his headache kept increasing. His initial BP was 123/76 (at the ED), his second BP was 142/88, the third BP was 160/P (I can't remember the diastolic) and then his final BP was 180/P. His heart rate was still in the 30's as well, BUT he was still A&O x PPTE. Then when we got him to the accepting facility the BP they got was 182/146. Something was very odd about the entire thing.
EDIT: A CT at the level 4 hospital didn't show anything
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lightsandsirens5
Forum Deputy Chief
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Yea. But within about 10 minutes they dropped to about 10, then within a few more they went below 8 and pretty soon after that they crashed.
abckidsmom
Dances with Patients
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No. The best GCS I've seen with Cushing's triad was at best 8, and likely less. It's been quite a while.
Sasha
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My toyota shakes at 67.
I asked her if she would take me to Miami, her response was "Hahaha... seriously though, how are you getting to Miami?"
Yes, my car talks.
fast65
Doogie Howser FP-C
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Yeah, I'm sure that within probably 15 minutes they had him intubated, we were damn close to doing it en route. I've just never seen anyone that alert with ICP like that, it was quite odd
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He's talking about Highway 67. A windy highway / road here in SD.
Sasha
Forum Chief
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My car still shakes.. really anything over 50..
Shake shake shake! Shake shake shake! Richard Simmons.... lol
Ugh, still sitting here at Pet/CT.grawr
JPINFV
Gadfly
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katgrl2003
Forum Asst. Chief
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Its a neon.... Mine decided to blow transmission lines while driving down the road. After replacing those, the radiator messed up, then there was an oil leak, then something else blew. I finally decided a new car would be less in payments then what I was paying each month to fix my car.
Sasha
Forum Chief
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Thats a dodge thing. My intrepids alternator died twice, killing the battery, then the tranny decided to go and i was like eff this :censored::censored::censored::censored:. Now i have an old toyota. Driving is an adventure.
Did he get a bolt in the ED?
Brown is convinced Brown is living in "Office Space" and has even figured out Brown is actually Samir Nagheenanajar because nobody can properly pronounce Brown's name.
Even Mrs Brown's mum can't remember Brown's name ...
AND ITS THREE LETTERS!
Um, yeah so about that, Brown is going to need you to all come in on Saturday .... and did you get that memo?
Even Mrs Brown's mum can't remember Brown's name ...
AND ITS THREE LETTERS!
Um, yeah so about that, Brown is going to need you to all come in on Saturday .... and did you get that memo?
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katgrl2003
Forum Asst. Chief
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Even Mrs Brown's mum can't remember Brown's name ...
AND ITS THREE LETTERS!
Why would she remember your name when she can just call you Kiwi Boy?
Why would she remember your name when she can just call you Kiwi Boy?
True.
Oh also Brown is having some sort of mental breakdown ... somebody call somebody.
Ghostbusters/ Mythbusters/ Men in Black/ XMen/ Capital City Goofball/ Intensive Care Paramedic... any will do
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