On a busy night shift, an ambulance brought a 28-year-old male after a seizure at home. He just arrived in Perth 3 hours ago from Europe. On arrival, his vital signs were as follows-
GCS 14/15
Pulse 132, BP 210/90, SaO2 95% on R/A, Temp 38.2, RR 24
BSL 8.9
In a busy night shift, a 42-year-old man was brought in by police after found in the train station agitated. He is still in the police van and very uncooperative.
The shift coordinator wants you to assess the patient.
You are about to see 2 brothers in the pediatric area, one 2 and another one 4-year-old. They were brought in by their mother, who is concerned that they may have had some of her iron tablets 1 hour ago at home. She pulled out at least 4-5 tablets from the younger one’s mouth.
According to the mother, there were 30 tablets in the bottle, with 105mg elemental iron in each tablet.
A 23-year girl was brought in ED by her mother in a wheelchair as she is refusing to walk. She is known to have borderline personality disorder and had multiple presentations before, with behavioral issues. During triage, she refused to talk to the nurse and kept her eyes shut.
Case-
A 72-year male, a retired car mechanic, presented to ED by ambulance at 0100 hours. He was found slumped over in his garage area, obtunded.
His initial vitals were- BP 100/60, HR 90, RR 19, Sats-94%, and BSL 15.
He takes an antihypertensive, a beta-blocker, insulin.
The ECG below is taken from a collapsed 70kg 56 yo man with a known mental health history, thought to have taken a multi-drug overdose.