Wednesday, July 23, 2008

Sinusitis into sepsis





It's been awhile since I posted, but most of what has come through was pretty routine: high risk surgeries, trouble extubating after surgery, Over doses, electrolytes imbalances, etc.

This case, however, was a little different. This patient had a sinus infection under treatment by her physician for over one week. Her relatives found her on the floor, unconscious, and laying in vomit. They brought her to the hospital. VS were 97.0-130-28-40/0. She had cyanotic extremities. O2 was started at 15+L/min on nonrebreather mask. The first ABG's and CMP are shown. An art line was started with difficulty. She was bolused with 3L of NS and brought to ICU. The morning came, she was put on nasal cannula after her first gases. She was awake, warm and dry, pain free, no resp distress. Pretty remarkable after only a few hours. Her morning CBC and ABGs are shown. Her antibiotic was changed to clindamycin. She was stable enough to be moved out to the floor.

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