Thursday, February 26, 2015

Emergency Simulation Case: Aspirin Overdose

A 65 year old male complains of nausea, vomiting, abdominal pain.

HPI: ringing ears, dizziness over 2 days.

PMHx: Osteoarthritis

Meds: Bayer aspirin, no known drug allergies (NKDA)

Social Hx: 
  • Alcohol in recent past
  • Quit smoking
  • Denies drug use
  • No travel hx
  • No new foods
  • No thoughts/attempts of suicide
Physical:
  • HR: 129
  • BP: 111/66
  • SpO2: 98
  • Temp: 38.1 C
  • Dry mucous membranes
  • Ok turgor
  • Breathing worsening
  • No peripheral edema
  • Took 2 Bayer pills every 2-3 hours over the past few days
Labs Ordered:
  • Bolus normal saline
  • Chem 7
  • CBC
  • Amylase
  • Lipase
  • Urinalysis
  • Toxicology
  • ABG
  • Chest and abdominal X-ray
Results:
  • High lymphocytes 55%
  • High fever
  • Salicylate level: 141
  • Clear chest/abdominal x-ray
DDx
  • salicylate overdose
  • respiratory alkalosis
  • issues spleen
  • duodenal ulcers
  • kidney
Assessment & Plan: 
  • Gave fluids and sodium bicarb
  • Repeat salicylate levels
  • Chest & abdominal xray
  • Dialysis
Take Home Points:
  • Look at likelihood ratios from tests that will point you in certain directions when making a diagnosis.
  • WBC could be a stress response, a way to rule out infection.

1 comment:

  1. There is a safe & effective Natural Herbal Medicine. For Total Cure Call    +2349010754824,  or email him   drrealakhigbe@gmail.com       For an Appointment with (Dr.) AKHIGBE contact him. Treatment with Natural Herbal Cure. For:Dengue Fever, Malaria. Painful or Irregular Menstruation. HIV/Aids. Diabetics. Vaginal Infections. Vaginal Discharge. Itching Of the Private Part. Breast Infection. Discharge from Breast. Breast Pain & Itching. Lower Abdominal Pain. No Periods or Periods Suddenly Stop. Women Sexual Problems. High Blood Pressure Chronic Disease. Pain during Sex inside the Pelvis. Pain during Urination. Pelvic Inflammatory Disease, (PID). Dripping Of Sperm from the Vagina As Well As for Low sperm count. Parkinson disease. Obesity, Lupus.  Cancer.  Tuberculosis.  Zero sperm count. Bacteria, Impotence Fertility,Toxoplasmosis, Diarrhea.Herpatitis A&B, Rabies. Asthma.  Quick Ejaculation. Gallstone, Cystic Fibrosis, Esquizofrenia, Cirrhosis,  Premature Ejaculation. Herpes. Joint Pain. Stroke. Coeliac Disease, Weak Erection.  Erysipelas, Thyroid, Discharge from Penis. HPV.  Hepatitis A and B. STD. Staphylococcus + Gonorrhea + Syphilis. Heart Disease.  Pile-Hemorrhoid.rheumatism,  Impotence, thyroid, Autism, Sepsis Bacteria,  Penis enlargement, Prostate Problem,  Waist & Back Pain.  Male Infertility and Female Infertility. Etc. Take Action Now. contact him & Order for your Natural Herbal Medicine:  +2349010754824  and email him    drrealakhigbe@gmail.com    Note For an Appointment with (Dr.) AKHIGBE.I suffered in Cancer for a year and three months dieing in pain and full of heart break. One day I was searching through the internet and I came across a testimony herpes cure by doctor Akhigbe. So I contact him to try my luck, we talk and he send me the medicine through courier service and with instructions on how to be drinking it.To my greatest surprise drinking the herbal medicine within three weeks I got the changes and I was cure totally. I don't really know how it happen but there is power in Dr Akhigbe herbal medicine. He is a good herbalist doctor.

    ReplyDelete