So yesterday I was looking after this guy with rhabdo, who came in with a CK of 243,100 and I was wondering - what's the highest value you've seen? Not necessarily CK, any value.
An example, for example - I had a woman who had a glucose of 120.8mmol/L. I don't know how to translate that into the US scale, but the normal range is around 4 - 9 in a well-controlled diabetic.
Same patient, different admission - triglycerides 8.1 (0.0 - 2.0), cholesterol 22 (?
Highest K+? 7.6mmol/L (renal patient)
Urea - 48.6, creatinine 1.18!!! (same patient, normal levels in June this year)
We were detoxing a young man from alcohol... giving him continuous
IV Ativan and IV Haldol was given every 2 hours. The dose of Haldol was 5mg at a pop.
The dose of Ativan was 40mg. PER HOUR.
Groggy, but still awake, pulling at restraints.
We triplequadruple checked the dosage... sure enough, 40mg/hr.
I would refuse to dose anyone w/ ativan 40 mg. (???). That doesn't make sense. I have detoxed may pt and have never heard of dosage like that. Also never have heard of Haldol use for withdraw. Sounds like an Internist's experiment. Would have the crash cart warm and ready.
In my early teens I was quite ill and had been taken to the emergency room, where they found my blood pressure to 345/151. Now I've never seen a blood pressure that high before, and I really thought their equipment was wrong but I have a print out around here from that ER visit with that printed on it. I had an Physician tell me that I was quite lucky to still be alive let alone be talking to them. Looking back on that I really can count my blessings that I'm still here. Also had a friend in High School that collapsed and had to be taken by ambulance, no one realized that he had diabetes and when he collapsed they found at the hospital that his glucose was up over 2700.
I was helping treat a patient in the ER with severe hyperglycemia, measuring in at 1200mg/dL. She was given insulin and her BS dropped to 21! Through the whole range of values, she was completely alert and oriented, but because of the shock, I was not. :-)
I remember seeing a lab patient with a K+ value of 37!!!! It was, of course, a typo on the lab slip and should have been 3.7, but it was discovered by the doctor, who came absolutely unglued!!! He yelled at EVERYONE wondering why no one else had noticed it. We were all a bit shaken up that day. You can bet that's never going to happen again.
Specializes in ER/Nuero/PHN/LTC/Skilled/Alzheimer's.
Just had a female today in clinical with a BNP of 1938. Could there possibly be any myocardial ischemic damage there? YEAH. Also had a guy who's FSBS was 23..and he was asymptomatic.
heartICU
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I have seen a platelet count of 2000, and a BP of 340/140 in a patient with pheochromocytoma. (These two situations were not the same patient:-)