Just Plain Ruff Posted July 16, 2007 Author Share Posted July 16, 2007 DC the D5W and replace it with LR. Dextrose containing solutions have no place in resuscitation. Any signs of drug overdose? Trauma? Breath sounds following securing the airway? Pulses generated with compressions? What's his temperature? What's the CO2 on the capnography show? trauma - nope Breath sounds are wonderful after you Azcep intubated the guy Pulses are generated with compressions Temperature 102.2 Co2 in capnography show a wonderfully excellent waveform Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted July 16, 2007 Author Share Posted July 16, 2007 What's his longer term medical history like? Cardiac? Any implanted devices? Surgery scars? unremarkable long term medical history Cardiac history - none no implanted devices No surgery scars Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted July 16, 2007 Author Share Posted July 16, 2007 Potasssium is low so a k-run is in order, other than that I am stumped. Work down the H's and T's till we rule everything out. you are getting close medic26 think outside the box What might the physician have ordered to correct some underlying problem. Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted July 16, 2007 Author Share Posted July 16, 2007 One thing that might make this clearer is that the labs were called to the ER about 10 minutes prior to the patient going into arrest. The patient was in X-ray when the labs were called. Something happened in that 10 minutes. What might have happened????? Link to comment Share on other sites More sharing options...
Medic26 Posted July 16, 2007 Share Posted July 16, 2007 The patient was given phenergan? Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted July 16, 2007 Author Share Posted July 16, 2007 you are on the right track Link to comment Share on other sites More sharing options...
AZCEP Posted July 17, 2007 Share Posted July 17, 2007 We need a potassium level immediately. Also consider switching from epinephrine to vasopressin. Hypoxia = managed with the intubation/BVM Hypovolemia = two large IVs with NS/LR Hypothermia = negative Hypo-/Hyper electrolytes = definite possibility Hypo-/Hyper metabolic = Not at present Tamponade = unlikely Tension pneumo = negative Tablets = aside from the effects of the phenergan, nope Thrombus, pulmonary = not likely Thrombus, cardiac = not likely Link to comment Share on other sites More sharing options...
BushyFromOz Posted July 17, 2007 Share Posted July 17, 2007 This has anything to do with the dye injected for contrast on the x-ray images?? Link to comment Share on other sites More sharing options...
Just Plain Ruff Posted July 17, 2007 Author Share Posted July 17, 2007 Azcep, you get your potassium level and it is way off the charts. It has nothing to do with radiological dye. Link to comment Share on other sites More sharing options...
AZCEP Posted July 17, 2007 Share Posted July 17, 2007 Bingo!! Sodium bicarb/CaCl/Albuterol ASAP. Do we have any electrical activity on the monitor, or is it still asystole? Might consider emergent dialysis, if it's available. Blasted phenothiazines anyway. Link to comment Share on other sites More sharing options...
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