abckidsmom
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I predict her pH to be 6.97.
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- Thread starter NomadicMedic
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I need to pay more attention to this at work...I never get to play! Everything's been covered pretty well already.
It seems like tox, but adrenal insufficiency would fit too.
Random, had she been depressed recently? There's talk of her ex husband. Is this a recent event? Some sort of suicide attempt by ingestion maybe? Any past attempts that the ex knows of?
Any chance we could get the labs from the ED?
It seems like tox, but adrenal insufficiency would fit too.
Random, had she been depressed recently? There's talk of her ex husband. Is this a recent event? Some sort of suicide attempt by ingestion maybe? Any past attempts that the ex knows of?
Any chance we could get the labs from the ED?
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NomadicMedic
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I'll get what I can. The hospital to which she was taken is notoriously bad for allowing Paramedic follow up. I've already called the ED doc and the intensivist.
So again, no history of anything… No past suicide attempts. No history of toxic ingestion. There were no drugs or alcohol found in the house. In a nutshell, "nobody seems to know nothing".
So again, no history of anything… No past suicide attempts. No history of toxic ingestion. There were no drugs or alcohol found in the house. In a nutshell, "nobody seems to know nothing".
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It may have already been asked and answered but had she been sick recently or complaining of anything per daughter? I kinda doubt this is something that just appeared out of nowhere but I'm new and am wrong all the time. Feel like this may have been building over a bit of time then all came to a crashing halt.
Tox seems like it's basically been "ruled out" with what we know. All that leaves is adrenal insufficiency or some sort of pancreatic problem like insulinoma or a problem with beta cells causing excessive release of insulin...can't remember the fancy name for that one.
They finally gave us these nifty little forms to request followup on our patients from the hospitals. Some of them will gladly just tell us, pull up labs, radiology, all their tests and let us go to town. Others are not so friendly. Helps to be friends in relatively high places at the ER as well
Tox seems like it's basically been "ruled out" with what we know. All that leaves is adrenal insufficiency or some sort of pancreatic problem like insulinoma or a problem with beta cells causing excessive release of insulin...can't remember the fancy name for that one.
They finally gave us these nifty little forms to request followup on our patients from the hospitals. Some of them will gladly just tell us, pull up labs, radiology, all their tests and let us go to town. Others are not so friendly. Helps to be friends in relatively high places at the ER as well
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NomadicMedic
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It's a head scratcher. Everything I got said she was normal prior. Ex said he didn't have much contact with her and the kid said as was fine.
I'm hoping to hear more today. I'm pretty tight with the ED manager, so I'm sure I'll be able to get something...
I'm hoping to hear more today. I'm pretty tight with the ED manager, so I'm sure I'll be able to get something...
abckidsmom
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I'm rushing back to this thread from Girl Scout cookie central just to hear what happened.
I hope I don't end up disappointed.
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NomadicMedic
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Luckily, through the magic of the Internet, you CAN'T miss anything in a threaded discussion if you go back and read from the beginning.
I haven't posted any of the labs, because I haven't obtained that information yet.
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abckidsmom
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Insulinoma would be so neat and tidy. And hypoglycemia from insulinomas I've seen comes with less diaphoresis. I'd say no to that since she's in the ICU. But I'm still on the edge of my seat.
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NomadicMedic
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Dana, she was not diaphoretic... She was cool and dry.
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NomadicMedic
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Just got off the phone. CT of her head was negative. pH was 7.1. K+ 7.5.
Verdict is acute liver failure.
Turns out she was a long term APAP abuser and fried her liver. Transferred out today to university hospital to get on the transplant list.
Verdict is acute liver failure.
Turns out she was a long term APAP abuser and fried her liver. Transferred out today to university hospital to get on the transplant list.
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NomadicMedic
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No. According to the crew, "ashen".
abckidsmom
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Interesting. Thanks for the followup. You didn't know her temp, did you?
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NomadicMedic
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I don't. I know we're having trouble getting our lifepak temp probes to correlate with the hospital thermometers.
abckidsmom
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We're having trouble getting our medics to think that temperature is something they need to check.
DesertMedic66
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We're having trouble getting our medics to think that temperature is something they need to check.
We don't carry thermometers.....
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NomadicMedic
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We have an axillary probe for the LP15. It's not usually right. We also have the "temp strips" that give you a guesstimate at temp.
abckidsmom
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You'll have more success if you lay it in the inguinal fold (fat crease in the groin).