Patient in unconscious state after vomiting

A patient presented in unconscious state. RR was very irregular with long apnoaeic periods, with a rate between 12 and 30. Nasal EtCO2 between 5.1 and 1.9 with a good trace. SpO2 unreadable but pt centrally cyanosed, HR between 80 and 200, BP initially 96/54 but central CRT was ~ 5 secs, temp - 35.6, bgl - 8.2. GCS was difficult to ascertain as it fluctuated hugely, but never greater than E4 V2 M4 - 10. No Allergies/PMHx/Meds, nil drug/alcohol usage. Only history was feeling “slightly unwell”, then relatives found collapsed. He had vomiting was the colour of the smoothie he recently drank. Above are the initial rhythms this pt was in, but these also fluctuated widely, between VT,?Torsades, Idioventricular and various others. IV Amiodarone, IV Lignocaine and synchronised cardioversion was attempted with nil success. Pt RSIed then SBP dropped to 44. How this patient should be managed?

2 Likes

LikeAnswersShare
Ecg shows VT/ VF.he must have had cardiac arrest what is the age of the pt.his cardiac rhythm should be controlled with iv amiadrone infusion BP should be controlled with vaspressors.most important is the etiology Once the sinus rhythm is achieved 2d echo may clear the diagnosis
MI with AF Needs regular monitoring and constant evaluation to avoid any complications. After pt stable with vitals normal further investigation and evaluation required to conclude and treatment plan.
Thanks Dr Kute Ankush
0

View 2 other replies

Ventricular fibrillation Irregularly irregular rythm Pt is in cardiac syncope Hypoxic as spo2 not traceable Likely myocarditis R/o covid19 sequele
Thanx dr Dinesh Gupta
0

View 1 other reply

Inferior wall MI Nodal rhythm Tall T waves like in hyperkalemia. Monomorphic VT. Needs cardioversion.
SUGGESTIVE OF VENTRICULAR ...FIB... POSSIBLY M. ! NEEDS. FURTHER. EVALUATION
? ACUTE MYOCARDIAL INFARCTION WITH VENTRICULAR FIBRILLATION...
Thanks Dr. Sandeep Ghodekar
0

View 2 other replies

? MYOCARDIAL INFARCTION.. WITH.. FIBRILLATION..
Tnx Dr Ashok Leel sir
0

View 1 other reply

Ventricular fibrillation with hypotension Adv Start Cardiopulmonary resuscitation 100 chest compression per minute Intubation with ambu bag ventilation 100 % oxygen It is a shockable rhythm, 200 joules biphasic defibrillator energy to be delivered, for converting in sinus rhythm If circulation is not restored then start CPCR again
VT -------> VF = Ecg BLOOD K + MG ++ Ca ++ TROP I RX IV FLUID INOTROPES HYPERKALAEMIA ? IV CALCIUMGLUCONATE 10 % 1O CC IV IN 2 MTS 02 INHALATION DC CARDIOVERSION IF SUCCESSFUL CAG IMMEDIATE PCI
Auricullar Fibrilation. Urgent cardiologist's intervention is sugfested. Pt must be admitted in ICCU..
Load more answers

Cases that would interest you