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This is a case that was posted in the private forum so several of you already saw it. Wanted to share it with everyone else.
Called from ICU to bring pt to OR emergently. On arrival, patient obtunded, tachypneic, tachycardic, hypotensive with SBPs in 80s, hypothermic @ 33.9 and mottled extremities. Pt has right SC TLC. Levo and vaso gtts running.
Surgeons have declared it an emergency and want to go to OR now for exlap. Patient is s/p gastric bypass several years ago.
Here's the ABG and CXR
pH 6.87
pCO2 23
pO2 277
Base Excess -27
Bicarbonate 4
Potassium 4.6
Hemoglobin 7.4
Hematocrit 23
Calcium 1.10
Glucose 138
Lactate 8.0
OR is ready for you. What next?
Called from ICU to bring pt to OR emergently. On arrival, patient obtunded, tachypneic, tachycardic, hypotensive with SBPs in 80s, hypothermic @ 33.9 and mottled extremities. Pt has right SC TLC. Levo and vaso gtts running.
Surgeons have declared it an emergency and want to go to OR now for exlap. Patient is s/p gastric bypass several years ago.
Here's the ABG and CXR
pH 6.87
pCO2 23
pO2 277
Base Excess -27
Bicarbonate 4
Potassium 4.6
Hemoglobin 7.4
Hematocrit 23
Calcium 1.10
Glucose 138
Lactate 8.0
OR is ready for you. What next?
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