Just Plain Ruff Posted November 9, 2008 Share Posted November 9, 2008 well according to the 12 lead he shows STEMI But I am suspecting some type of electrolyte disorder that caused it. Those T-waves are really really spiked. I suspect marked hyperkalemia here is a great article. http://www.chestjournal.org/cgi/reprint/62/1/24.pdf Link to comment Share on other sites More sharing options...
chbare Posted November 9, 2008 Author Share Posted November 9, 2008 If hyperkalemia, what is the cause? Are you going to treat for hyperkalemia? Take care, chbare. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted November 9, 2008 Share Posted November 9, 2008 well I'm gonna get him to definitive treatment, the clinic. Run some labs, troponin, lytes and all that. What are my labs chem12 or chem 22 cbc troponin then I'll know what next I need to do Link to comment Share on other sites More sharing options...
chbare Posted November 9, 2008 Author Share Posted November 9, 2008 What about his vital signs and runs of ventricular tachycardia? I will let you guys have labs; however, do we need to consider additional interventions while waiting? Take care, chbare. Link to comment Share on other sites More sharing options...
ERDoc Posted November 9, 2008 Share Posted November 9, 2008 Have we stripped him down and looked for other similar blisters? I think that given the location this happened in we need to check the others quick for blistering. Link to comment Share on other sites More sharing options...
chbare Posted November 9, 2008 Author Share Posted November 9, 2008 You note a large reddened area to his left foot. In addition, his pupils are 5 mm and sluggish to react bilaterally. Otherwise, the exam is unremarkable with the exception of the findings previously discussed. Take care, chbare. Link to comment Share on other sites More sharing options...
AnthonyM83 Posted November 9, 2008 Share Posted November 9, 2008 Anything further upon a detailed assessment (after exposing patient, cutting equipment, etc)? O2sat, any spontaneous respirations, skin signs, any known hazards where he was working (chemical, electrical). Could the blister be from a thermal burn? Does it look more like an allergic reaction? Does it look new? History, Allergies, Meds? Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted November 9, 2008 Share Posted November 9, 2008 traumatic cardiac arrest, treat the cause electrocution is straight forward - cover the burns wiht dry sterile dressings Treat the cardiac arrest or runs of v-tach with lidocaine (ACLS Dose) or amiodarone The airway is secured by the airway they have but do we have good breath sounds or due to the fall do we have other findings What is the patients LOC Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted November 9, 2008 Share Posted November 9, 2008 Was there a recent rainstorm? from a article found here http://www.viamedica.pl/gazety/gazeta1/dar...indeks_art=1172 Lightning strikes can result in a variety of injuries including burns and non-cardiac injuries, as well as cardiac arrest and subsequent brain death. Currently, an estimated 50–300 deaths per year in the United States are attributed to lightning causes, with an additional four to five times that number of injuries [4]. One manner in which lightning injury may occur is when a person is touching an object that is part of the pathway of lightning current, the phenomenon of side splash or flash as the current flows through the pathway of least resistance. Blunt injury can also occur, either if the person is thrown as the result of a massive muscular contraction or due to an explosive force Link to comment Share on other sites More sharing options...
chbare Posted November 9, 2008 Author Share Posted November 9, 2008 Patient is unresponsive. Saturations were in the high 90's. You are not able to obtain a pressure or note a pulse oximetry wave form. A weak carotid pulse is noted however. Unknown history. The blister and skin redness appear "new." The redness resembles a sunburn. Take care, chbare. Link to comment Share on other sites More sharing options...
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