June 2015 critical care case of the month: just ask the nurse

• Main Author: Raschke RA
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2015-06-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: aortic dissection; hypotension; confusion; medistianl widening; chest x-ray; CT scan; thoracic CT scan; different blood pressure; treatment; chest pain
• Online Access: http://www.swjpcc.com/critical-care/2015/6/2/june-2015-critical-care-case-of-the-month-just-ask-the-nurse.html

No abstract available. Article truncated after 150 words. History of Present Illness: A 61-year-old police officer had just finished a speech at a conference in Phoenix when he developed sudden, sporadic unresponsiveness. He complained of chest pain which he described as tingling. He became diaphoretic cyanotic, and vomited. Emergency medical services was called. They noted a blood pressure of 80/50 mm Hg, a pulse of only 45, temperature of 95º F, a respiratory rate of 12, and widely dilated pupils. He was transported to the emergency room. PMH, SH, FH, Medications: Unknown. Physical Examination: Vital signs: blood pressure 120/75 mm Hg with a leg cuff, pulse 43 and irregular, temperature 96º F, respiratory rate 10, SpO2 96% on O2 @ 5L/min by nasal cannula; Neck: No JVD. Carotid pulses could not be palpated. Lungs: Poor inspiratory effort; Heart: Irregular rhythm without a murmur; Neurological: Delirious – mute – won’t obey commands or track with his eyes; Pupils 3 mm reactive ...