Critical Care

An Interesting Case of Ingestion by Dr. Loran Hatch

A 20 year-old female presents with an intentional overdose. Her mother reports that 30 tablets of Meloxicam 15mg missing. Patient alert and she complaints of generalized abdominal pain and nausea. Vitals are initially stable, but then she becomes hypotensive 50s/20s while she is alert. Her ECG is NSR and wide QRS (146ms) and prolong QTc (762ms). The patient eventually admits to also taking her mother’s Plaquenil.
 
 
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Board Review: Drowning

A 2 year old boy is brought to the Emergency Department after a drowning event. Bystanders noted the child was underwater for 1 minute but was quickly pulled from the bottom of the pool, he coughed and vomited. On arrival, he is aware and alert and behaving appropriately per parents. His GCS is 15. On examination, he has a heart rate of 110, respiratory rate of 30 breaths/minute SaO2 of 98% on room air. His lungs are clear. What is the next step in management? 

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Back to Basics: Decompression Illness

While the scuba diving decompression illnesses of decompression sickness and arterial gas embolism are treated the same, the pathophysiology and presentation are different.

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