After several phone calls to the residence from dispatch and a discussion with the patient’s daughter, the fire department gains entry through a window in the back of the house.
The patient is found lying supine on the kitchen floor.
She is unresponsive with dried vomitus around the mouth.
Vital signs are assessed.
RR: 8 and shallow
Pulse: 46 and irregular
BP: 102/70
The cardiac monitor is attached.
SpO2: Initially does not register
Airway reflexes are absent.
The patient is intubated.
SpO2: 100 with oxygen via BVM
ETCO2: 20 mmHg
An IV is established.
BGL: 140
1 mg atropine and 2 mg naloxone are given with no effect.
Skin is pale and cold to the touch.
Physical exam reveals no head trauma.
A 12-lead ECG is captured.
You are 10 minutes from the local non-PCI hospital and 45 minutes from a STEMI Receiving Center.
What do you think is going on here?
I'm seeing J-waves present which typically happens to pt. who are hypothermic. Could she of possibly had an MI? Yes! Which caused her to be hypothermic. Definitely check her Temp.
ReplyDeleteGreat Job Chico, You were spot on with your diagnosis, I like that you took the time to research your answer. Well done!!!
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