ECG Case 079
57 year old female presents following a collapse at work. Describe and interpret this ECG. LITFL Top 100 ECG
Potassium toxicity
Potassium clearly has its potential for risks including life-threatening hyperkalaemia and cardiac arrest. It is very concerning that the slow-release preparation is available in bottles of 100 without prescription. Aggressive decontamination and haemodialysis are indicated in large overdoses.
Thyroxine toxicity
Thyroxine overdose rarely causes hyperthyroidism, if it does, symptoms are usually mild and can be managed as an outpatient.
Mercury toxicity
Fortunately mercury poisoning is very rare. The risk of toxicity depends on the type of mercury you have been exposed to. Elemental mercury is found in thermometers, barometers, paints, and pigments, these are benign presentations unless aerosolised
Theophylline toxicity
Theophylline has a narrow therapeutic index, both acute and chronic overdose is potentially life-threatening requiring aggressive supportive care and dialysis to ensure a good outcome
Isoniazid toxicity
Isoniazid overdose is rare but life threatening. Isoniazid can cause refractory seizures which require the specific antidote pyridoxine. It should be thought about in cases of status epileptics where this is a relative or a potential history of TB in the family.
Baclofen toxicity
Baclofen in overdose produces a rapid onset of delirium, respiratory depression, coma and seizures. In large overdose the patient can appear brain dead and it has resulted in the pursuit of organ donation only for the patient to wake on the operating table. The mainstay of treatment is good supportive care.
ICE 007: Abdominal pain investigations
A 57 year old man presents to the ED with 18 hours of severe upper abdominal pain, fever, nausea and vomiting. He looks jaundiced, his HR is 120bpm, BP 110/60, RR 22 and his temperature is 37.8oC. He is tender and guarded in his right upper quadrant on abdominal palpation.
CICM SAQ 2011.2 Q1
List the complications and their likely underlying mechanisms specifically related to cardiopulmonary bypass that may be seen in the Intensive Care Unit following cardiac surgery.
CICM SAQ 2013.2 Q1
A 76-year-old female is admitted to the ICU following elective aortic and mitral valve replacement. Transoesophageal echo assessment at the end of surgery showed an ejection fraction of 20%. Her preoperative creatinine was 340 micromol/L. Total bypass time was 240 minutes.
CICM SAQ 2012.2 Q17
With regards to the determination of brain death; list the preconditions that must be met prior to the determination of brain death by clinical criteria
Funtabulously Frivolous Friday Five 189
Funtabulously Frivolous Friday Five 189 - Just when you thought your brain could unwind on a Friday, some medical trivia FFFF.