ER Hall of Fame

[Mount Asclepius]

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It’s an impressive collection of pathogens. Possibly similar though to a polymicrobial pneumonia or wound infection in an immunocompromised host. Also wonder if possible cross reactivity overlap as the vibrio species from the cholera and the multiple forms of E. Coli seems interesting. Would love to hear an ID physician’s opinion.

 

[pkwraith]

Our ID doctor didn't have much intellectual curiosity about this case, just called the lab to make sure the PCR was correct, and ordered oral vanc and moved on.
I imagine there is some PCR overlap, but frankly, I'm not surprised after the decon we had to do on the guy when he first got in. I'm actually more surprised he wasn't positive for any parasites.

 

[Boatswain2PA]

Bili of 45.5. Not the record (someone here had 53), but pretty close!

 

[Powdermonkey]

Can we make a sticky for labs that are extreme high/low? I think we would need to keep the first post updated by mods somehow to update it when new records come in. Post with a screenshot and no identifying markers on it? We collectively see some insane crap in our specialty. Let's share it!

I can go first.

This is a new glucose record for me:

 

[BoardingDoc]

I moved your post here since you were asking me or @southerndoc to make something which already existed.

As to the sticky comment: there is a sticky post already called "popular threads" which has a link to this in it.

 

[Powdermonkey]

I moved your post here since you were asking me or @southerndoc to make something which already existed.

As to the sticky comment: there is a sticky post already called "popular threads" which has a link to this in it.

Thanks, didn't catch it there!

 

[HemeOncHopeful19]

I’ll contribute my most impressive lab, I’m not ER but I’m sure this was drawn in the ER so I guess it counts

Highest WBC 885.6

CML patient had stopped their treatment

 

[battie]

Can we make a sticky for labs that are extreme high/low? I think we would need to keep the first post updated by mods somehow to update it when new records come in. Post with a screenshot and no identifying markers on it? We collectively see some insane crap in our specialty. Let's share it!

I can go first.

This is a new glucose record for me:

View attachment 405102

There's a lot of fun on that sheet overall, tbh.

 

[BoardingDoc]

At least their Na is actually normal when you correct for that glucose. MDCalc gives me an error when I try to enter a glucose of over 2k, but it manually works out to about 143 for me.

 

[TooMuchResearch]

I’ll contribute my most impressive lab, I’m not ER but I’m sure this was drawn in the ER so I guess it counts

Highest WBC 885.6

CML patient had stopped their treatment

That's wild.

 

[Powdermonkey]

At least their Na is actually normal when you correct for that glucose. MDCalc gives me an error when I try to enter a glucose of over 2k, but it manually works out to about 143 for me.

The best part is he promptly decided to spew hematemesis across the room and then bought himself a tube. And his pancreas was normal on CT on the way to the ICU. He sadly expired later that day, but holy dang he was sick.

 

[gutonc]

The best part is he promptly decided to spew hematemesis across the room and then bought himself a tube. And his pancreas was normal on CT on the way to the ICU. He sadly expired later that day, but holy dang he was sick.

I think we all saw that coming.

 

[DOswag]

I remember reading through this thread when I was a lowly ER tech premed back in like '07-'10 lol! Had some pretty astonishing lab values I saw back then but these are just incredible.

 

[USCDiver]

Smallest neonate successfully resuscitated: 1200g (precip delivery from mom with no PNC in a rural hospital with no Ob, no Peds/NICU, and no supplies appropriate for a baby that small.) 😢

We had to manually bag for 2+ hours waiting for a NICU team to fly in with small enough tube and surfactant.

 

[Apollyon]

What is the gest age? I'm guessing near 30 weeks, but not yet - 28 maybe?

 

[USCDiver]

What is the gest age? I'm guessing near 30 weeks, but not yet - 28 maybe?

Your guess is as good as mine, but probably in that range per the NICU folks.