Skip to content

68 yo female unresponsive on the kitchen floor

by on February 3, 2011

EMS is called to perform a “health and welfare” check on a year old 68 year old female who has not been seen by the neighbors for at least 24 hours.
After several phone calls to the residence from dispatch and a discussion with the patient’s daughter, the fire department gains entry through a window in the back of the house.
The patient is found lying supine on the kitchen floor.
She is unresponsive with dried vomitus around the mouth.
Vital signs are assessed.
RR: 8 and shallow
Pulse: 46 and irregular
BP: 102/70
The cardiac monitor is attached.

SpO2: Initially does not register
Airway reflexes are absent.
The patient is intubated.
SpO2: 100 with oxygen via BVM
ETCO2: 20 mmHg
An IV is established.
BGL: 140
1 mg atropine and 2 mg naloxone are given with no effect.
Skin is pale and cold to the touch.
Physical exam reveals no head trauma.
A 12-lead ECG is captured.

You are 10 minutes from the local non-PCI hospital and 45 minutes from a STEMI Receiving Center.
What do you think is going on here?

Advertisements

From → Case File

2 Comments
  1. >I'm seeing J-waves present which typically happens to pt. who are hypothermic. Could she of possibly had an MI? Yes! Which caused her to be hypothermic. Definitely check her Temp.

  2. >Great Job Chico, You were spot on with your diagnosis, I like that you took the time to research your answer. Well done!!!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: