A 66-year-old man with a history of hypertension and smoking complains of acute-on-chronic dull, unrelenting abdominal and back pain over the past several hours. He has been “under a lot of stress lately” and occasionally suffers from anxiety. He has no fever, nausea, vomiting, or diarrhea. His vital signs show T 37.8 HR 92 BP 166/80 RR 12 98% RA. His exam shows diffuse mild abdominal tenderness to deep palpation; he has normal pulses. A bedside ultrasound of his abdomen is very limited by habitus and bowel gas.
A CT abdomen/pelvis is ordered with IV contrast. During the scan, your patient has difficulty breathing and becomes diaphoretic. You respond to the radiology suite to find a flushed man in moderate distress with wheezing. Regarding his management, which of the following is the single BEST answer:
A) He should never be given IV contrast again
B) Give steroids and diphenhydramine and watch for improvement; hold the epinephrine for now due to his age and risk factor.
C) Give 0.5 mg of 1:1,000 epinephrine IM now.
D) Give 0.3 mg of 1:10,000 epinephrine IM now
In the meantime, a quote -- "For want of timely care, Millions have died of medicable wounds." - John Armstrong, physician and poet (1710-79) Act of Preserving Health
A CT abdomen/pelvis is ordered with IV contrast. During the scan, your patient has difficulty breathing and becomes diaphoretic. You respond to the radiology suite to find a flushed man in moderate distress with wheezing. Regarding his management, which of the following is the single BEST answer:
A) He should never be given IV contrast again
B) Give steroids and diphenhydramine and watch for improvement; hold the epinephrine for now due to his age and risk factor.
C) Give 0.5 mg of 1:1,000 epinephrine IM now.
D) Give 0.3 mg of 1:10,000 epinephrine IM now
In the meantime, a quote -- "For want of timely care, Millions have died of medicable wounds." - John Armstrong, physician and poet (1710-79) Act of Preserving Health
RSS Feed