So here's the scoop. I work in a small community hospital- a general ICU. The bottom line is- everyone- including our doc's are completely stumped. Here's the details...
57 y/o female
HX: HTN, depression, MI, cardiac stent x2, lap chole 2006, non-IDDM.
At home- house was treated for bugs- (bombed is what I got in report)
after approx 3 hours, EMS called by friend stating pt has a seizure.
Pt brought to ER- Combative, agitated, non-verbal, hypertensive (212/110), tachycardic (140-160's) kussmaul respirations, low grade fever (100.9). FSBS 236. BUN 21/creatinine 2.1
Pt transferred to PCU- continued HTN 200's/100's with PRN Hydralizine order. after 1 hour on PCU order to Tx to ICU- no order for Nipride or Labetalol.
Pt continued as above- pt appears diaphoretic- EKG- ST/SVT 150-160. Adenosine given- no response.
CT head- small white matter changes- appear chronic. NO ACUTE PROCESS SEEN.
Any ideas- nothing- not Ativan, Haldol, or Valium calmed her down. None of the doc's seem to have any ideas as to what is wrong with her. I consider myself pretty smart- but for the life of me- I can't figure this one out. we gave her Dilantin IV b/c they thought she may be having seizures- but honestly I don't think thats whats going on. Her ETOH and Tox were neg.
thanks for any input....