|
Abstract
|
After consent was obtained by the patient's father, we drafted this report for Resident Rounds.
A previously healthy teenage male, with increasing depression the previous 6 months, presented to our institution's pediatric intensive care unit (PICU) after a mixed overdose. He was last seen well by his sister on 2/8/22 at 23:00. His father found him unconscious (face down and covered in vomitus on 2/9 at 03:00 without any intravenous drug paraphernalia). The patient was taken to the closest emergency department where his initial vitals were 187/75, heart rate (HR) 137, respiratory rate (RR) ~40, O2 87% on nonrebreather, and a glascow comma scale (GCS) of 3. Head computed tomography (CT) was negative for acute intracranial abnormality. Exam was notable for fixed and dilated pupils to 6 mm; no cough or gag. He was promptly intubated for airway protection and low GCS. Arterial blood gas (ABG) was 7.04/49/137/14/-17 demonstrating a primary metabolic acidosis with a secondary respiratory acidosis. Other pertinent labs were blood urea nitrogen (BUN) 13, creatinine (Cr) 1.21, K 4.1, Gluc 358. He did not receive activated charcoal, and furthermore oral ingestion was the presumed mechanism of action as evidenced by elevated drug levels obtained in the PICU admission. ...
Language: en |