emt322632 Posted November 11, 2007 Author Share Posted November 11, 2007 Alrighty...this case had me stumped to. We transported her to the ER, very uneventful transport in and of itself. The bigeminal PVCs went away on their own, she reverted to RSR at 88. I gave 2mg of narcan just to see if it would have any effect on her mental status, when we got her to the ER she was slightly more awake, but was still unable to vocalize or follow commands. When we were leaving, one of the nurses said it looked like a possible brain bleed. However, the next day when I went to work ( I work at the hospital we transported her to) I found out the problem.... Hepatic encephalopathy. Had to look it up, but all her symptoms fit. http://www.nlm.nih.gov/medlineplus/ency/article/000302.htm Just don't really know how the liver failure came about, her husband said she had no medical history except her back surgery. Link to comment Share on other sites More sharing options...
Eydawn Posted November 11, 2007 Share Posted November 11, 2007 Quote: "In people with otherwise stable liver disorders, hepatic encephalopathy may be triggered by gastrointestinal bleeding, eating too much protein, infections, renal disease, procedures that bypass blood past the liver, and electrolyte abnormalities (especially a decrease in potassium). A potassium decrease may result from vomiting, or treatments such as paracentesis or taking diuretics ("water pills"). Hepatic encephalopathy may also be triggered by any condition that results in alkalosis, low oxygen levels in the body, use of medications that suppress the central nervous system (such as barbiturates or benzodiazepine tranquilizers), surgery, and sometimes by co-occurring illness." http://www.nlm.nih.gov/medlineplus/ency/article/000302.htm There's your answer as to how it maybe came about... Wendy CO EMT-B Link to comment Share on other sites More sharing options...
shannon710 Posted November 11, 2007 Share Posted November 11, 2007 very interesting..good one emt322632!! Link to comment Share on other sites More sharing options...
mobey Posted November 12, 2007 Share Posted November 12, 2007 Thanks for the scenario! Link to comment Share on other sites More sharing options...
Kaisu Posted November 12, 2007 Share Posted November 12, 2007 cool.. I can hardly wait till we start learning about the liver. Link to comment Share on other sites More sharing options...
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