Round 8 (Fall)

Summary: <br> CAUTION: THESE NOTES CONTAIN SPOILERS!!!<br> <br> <br> <br> Case Introduction<br> <br> <br> <br> EMS brings in an elderly man who has fallen…<br> <br> <br> <br> Initial Vitals<br> <br> <br> <br> * Temp 98.6* HR 58* RR 16* BP 105/60* 99%<br> <br> <br> <br> Critical Actions<br> <br> <br> <br> * Treat the patient’s pain* Consult orthopedics for a hip fracture* Obtain an EKG* Treat Severe Hyperkalemia* Consult nephrology for dialysis<br> <br> <br> <br> Final Diagnosis<br> <br> <br> <br> Ground level fall resulting in hip fracture, missed dialysis, and severe hyperkalemia<br> <br> <br> <br> Tips and Tricks<br> <br> <br> <br> Patient’s will frequently have more than one final diagnosis. Do not prematurely close an the initial, obvious, diagnosis.<br> <br> <br> <br> A man can have as many diseases as he damn well pleases! Hickam’s dictum<br> <br> <br> <br> Additional Reading<br> <br> <br> <br> * Basic approach to hyperkalemia <a href="http://www.emclerkship.com/hyperkalemia-critical-diagnosis/">(EM Clerkship)</a>* EKG manifestations of hyperkalaemia <a href="https://litfl.com/hyperkalaemia-ecg-library/">(LITFL)</a><br> <br> <br> <br> <br>