что такое город? (флуд из другой темы)

[Donat]

was she tubed?

DNI

saturating 99% on NC2litO2
RR 16-20 at first
when hypotensive RR went up to 35-40 with Sat of 99%
started on Neo, Dopa, Levo

[FOLEY]

DNI

saturating 99% on NC2litO2
RR 16-20

and HR?

(p.s. you on call tonight?)

[Donat]

and HR?

(p.s. you on call tonight?)

baseline HR:80-85
when in shock HR: 120-130 (A-fib)
A-fib was controlled on B-blockers and Ca-chan blockers (Cardizem)

[Donat]

no I am not on call
i know it's time to go to bed

[FOLEY]

no I am not call
i know it's time to go to bed

stay up..let's investigate this further! (i am starting to feel a bit out of touch - as I've been out of the ICU for several weks now)

[FOLEY]

baseline HR:80-85
when in shock HR: 120-130 (A-fib)
A-fib was controlled on B-blockers and Ca-chan blockers (Cardizem)

and during this period no ischemic changes on the monitor?

[Donat]

and during this period no ischemic changes on the monitor?

I did EKG: controlled A-fib @ ventricular rate of 90, no ST-T changes
Troponin I: 0.01
CK: about 200
% MB about 5%

[Donat]

previous EF: 35-40%

I was thinking about cardiogenic shock also, but no, doubtful
could be some IVF overload also, but not that bad, on CXR some mild CHF

[FOLEY]

ok..so cardiogenic shock can be crossed off the list.

what are we left with?

anaphylactic shock - unlikely but remotely possible
neurogenic shock - a stronger possibility
septic shock - the strongest possibility


anaphylaxis - any signs? any weitd IV's started peri-death period? any rashes? (seems so unlikely given the fairly stable respiratory status)

neurogenic - also slim evidence. if she was that depressed neurologically to drop BP, her HR would have not responded...

so we still have to go with sepsis, no?

[FOLEY]

previous EF: 35-40%

I was thinking about cardiogenic shock also, but no, doubtful
could be some IVF overload also, but not that bad, on CXR some mild CHF

CHF initially would have increased BP anyway...so it is doubtful