More than just strips, there is a case to go with them. I’ll present Part 1 today and the answers tomorrow. As always, details are changed to obscure patient identities without changing the clinical portions of the case.
65 year old male complaining of more than one week of “general malaise” for lack of a better term. No specific complaint, just not feeling good. Has had decreased PO intake secondary to “not feeling like eating” over the same time period.
History of Hypertension, “irregular heart beat”, but no specific cardiac diagnosis. Medications are Coumadin, Digoxin, Lisinopril, Klor-Con, and Lasix. No Known Drug Allergies.
Conscious, alert, oriented to time, place, and person. Answers appropriately, but it is obviously an effort to concentrate. Skin is ice cold, but dry. Breath sounds are clear, equal, and with good tidal volume. Thready and intermittent radial pulses felt, but no blood pressure can be auscultated or palpated. No neurological deficit noted. Blood Glucose (patient is not diabetic) is 47 mg/dl. No pedal edema noted. No O2 saturation can be obtained.
And a 12 Lead EKG
What is the rhythm? Is the rhythm causing the malaise or is whatever is causing the malaise also causing the rhythm? What is your plan of treatment?
Answers tomorrow, as well as what how we treated this gentleman. I’m also not going to reply to comments until tomorrow. Which should not stop my readers from commenting.