Case of the week 10


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.

  • What are the possible causes of this presentation?
  • How will you initially approach the situation?

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Lab Case 1

Describe and interpret this arterial blood gas:

History: 45y male found in his garage. Brought in by ambulance with altered mental state.  His arterial blood gas on arrival (FiO2 = 0.21%):

pH 6.90                                                                Na 153

pCO2 20                                                               K 4.1

pO2 115                                                                Cl 109

HCO3 4.0                                                              Glucose 5.2

COHb <1.0%                                                         Urea 5.5

Ethanol <0.01%                                                      Osmolality  335