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)
I'm just a nursing studentl, but in clinicals last semester one of our assigned patients had a blood glucose of 6! And my classmate wondered why he wouldn't get up to take his PO meds!? :chuckle
We get tons of ETOH w/d patients. ALmost 1/2 of all trauma pts have some sort of ETOH connection (them, the person that ran over them, the driver, etc). Highest BAL I have seen is a chronic ETOH pt that was over 1100. Hospital record. He was in Korsakoff's dementia, couldn't really even speak/function with no ETOH on board. Pretty sad. YOu have to have a very special liver to get an ETOH level that high. And this was a guy who was conscious, walking and talking when he was brought into the ER after being assaulted.
Had a patient a couple weeks ago who had fallen at home and of course couldn't get up, laid in his own urine and stool for a few days, dehydrated as hell, I can't remember his labs but his temp when he came in was 84.0 F rectally. He bought himself some time in the ICU.
hispanic female looks about in her 60's c/o all over body rash very pruritic. hx: diabetic takes NPH/Regular doesn't check her blood sugar on a daily basis. We investigate more on her diabetic history. got very upset because we weren't addressing her 'rash'. Accucheck 'Critical High', Chem7 Glucose 1011. Went to
ICU for insulin drip. Alert/Oriented/ Conversant/In her 40's.
P.S. We gave her Bendaryl for her itch. Was satisfied with that.
We get tons of ETOH w/d patients. ALmost 1/2 of all trauma pts have some sort of ETOH connection (them, the person that ran over them, the driver, etc). Highest BAL I have seen is a chronic ETOH pt that was over 1100. Hospital record. He was in Korsakoff's dementia, couldn't really even speak/function with no ETOH on board. Pretty sad. YOu have to have a very special liver to get an ETOH level that high. And this was a guy who was conscious, walking and talking when he was brought into the ER after being assaulted.
Wow...and I thought my guy who came in walking and talking with a BAC of 776 was amazing!
Specializes in Acute Care Cardiac, Education, Prof Practice.
INR: 10.1 Pt was on Coumadin and had been drinking a lot of herbal tea at home.
BNP's all over the the 5000-9000 range. (Cardiac floor, lots of CHF'ers)
One BP of 65/54 on my 30 year old obese patient. I promptly went and showed my tech how to properly take a BP on the forearm... :smackingf
H/H 3/10 on a s/p outpatient 17 year old lap chole. Wasn't even my patient, but I went in and told her mom to not stop pushing until they had done a CT of her abd. They finally did one at 5pm the following afternoon (I work nights) and found 400mL blood in her abd.
My aunt has had 4 different types of cancer since I was a child. Once her platelets were 2. Just 2. A cousin of mine was admitted to ICU last month b/c he fell at home and broke his leg. His b/p was 50/30...he was in septic shock, acute renal failure, liver failure (long ETOH hx), tib/fib fx, acidosis, and pneumonia. He was on a vent for 2 weeks. Turns out that breaking his leg saved his life. He's doing better now.
sleepless in norman
115 Posts
I have one question, Where have these patients received their previous medical/behavioral care, these quantitatives are outrageous. 's with wolves.