ERDoc Posted June 11, 2009 Share Posted June 11, 2009 Forgive my ignorance please. Is Benadryl a commonly used anti-emetic? I had no idea an anti-histimine would function as such. How much would you give in this case, taking into account the additive effects Benadryl has on alcohol and benzodiazapines? Benadryl does have some anti-emetic properties, but there are much better choices. I would avoid it in this particular case because of it's sedating effects as well as it's possible interactions with anything she may have taken. I would go for zofran as an anti-emetic. Link to comment Share on other sites More sharing options...
mobey Posted June 11, 2009 Share Posted June 11, 2009 Interesting vitals indeed. Especially the HR. 12 lead? Odour on the breath? Any more info from the Ho's? The history is screaming dehydration, but the vitals are just not consistant with hypovolemia. Intubate fluid bolus repeat BGL Are the pupils responsive? This could easily be a closed head injury (bleed, CVA, tumor etc) Just to be different I may choose Maxeran as an anti-emetic Link to comment Share on other sites More sharing options...
chbare Posted June 11, 2009 Share Posted June 11, 2009 Just to be different I may choose Maxeran as an anti-emetic I would steer clear of Maxeran. (Reglan for your southern mates, or Maxolon in other countries.) Without a really clear history and the presence of seizures, this medication could precipitate additional problems. In addition, the risk of EPS may be higher in this patient, as we do not yet have a clear idea of what is going on, or what other substances are on board. I have my suspicions, but will keep them to my self for now. Take care, chbare. Link to comment Share on other sites More sharing options...
Mateo_1387 Posted June 11, 2009 Share Posted June 11, 2009 Forgive my ignorance please. Is Benadryl a commonly used anti-emetic? I had no idea an anti-histimine would function as such. How much would you give in this case, taking into account the additive effects Benadryl has on alcohol and benzodiazapines? Just food for thought, Phenergan is a histamine blocker, and is used as an anti-emetic. Link to comment Share on other sites More sharing options...
chbare Posted June 11, 2009 Share Posted June 11, 2009 Promethazine also antagonizes dopamine, hence the association of EPS, NMS, and the such. Take care, chbare. Link to comment Share on other sites More sharing options...
Jeepluv77 Posted June 11, 2009 Share Posted June 11, 2009 Do the sorority sisters say anything about this "partying"? Was she drinking or using drugs? Her bp is kinda high, hr low, rr high. Since we don't appear to be getting much from "da hos" does she show any signs of trauma or chronic alcohol use? I say fudge the fluid bolus, run it kvo. The bp is already rising and too high. Also, is she still perfusing adequately? I'd get ready to pace(hr 50) and if she's not perfusing well get that started. Oh, and get her on the nrb @15. May bring that hr up a little. Maybe not, but worth a try. What's her skin turgor like, btw? Link to comment Share on other sites More sharing options...
Kiwiology Posted June 12, 2009 Author Share Posted June 12, 2009 Foregive me I'm not too up on all those blood tests and this is starting to get a bit above my head so I will forego firing off a lot of "normal" values when they may infact not be normal and misleading everbody. The important stuff is below Serum osm 200 CSF osm > serum (unable to find a normal range) Urine NA is 40 Urine osm is 250 FENa .14 UP Creat 150 Preg neg BAC 0 BGL 6 Link to comment Share on other sites More sharing options...
ERDoc Posted June 12, 2009 Share Posted June 12, 2009 How about a chem7/cmp/lytes, BUN, creatinine (whatever your local term is)? Link to comment Share on other sites More sharing options...
chbare Posted June 12, 2009 Share Posted June 12, 2009 Foregive me I'm not too up on all those blood tests and this is starting to get a bit above my head so I will forego firing off a lot of "normal" values when they may infact not be normal and misleading everbody. The important stuff is below Serum osm 200 CSF osm > serum (unable to find a normal range) Urine NA is 40 Urine osm is 250 FENa .14 UP Creat 150 Preg neg BAC 0 BGL 6 Would you identify the units of measurement as well? This can vary from country to country depending on the lab test. Using a reference range of 285-295 mOsm/kg for the normal serum osmolality, it would appear to be a bit on the low side. Since you need a serum sodium, glucose, and BUN to calculate serum osmolality, would these findings be available? (I do notice the BGL of 6.) The serum sodium would be of particular interest. Take care, chbare. Link to comment Share on other sites More sharing options...
Kiwiology Posted June 12, 2009 Author Share Posted June 12, 2009 OK I've looked into it more; all lytes, CBC, ABG, BUN and creat are WNL except what I put above The UA shows UrNa at 40 mEq/L Link to comment Share on other sites More sharing options...
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