Monday, 17 May 2010

67 y/o male CC: Syncope

A 67 y/o male has fallen to the ground at his residence. His "partner" called 911 after seeing that he was unconscious. Upon your arrival the patient is alert and requesting that you pick him up because he really needs to make a bowel movement. The patient denies syncope but states that he does not remember falling.

Here is the initial ECG and the subsequent 12-lead ECG. Sorry for the poor quality.

What do you see?

What do you want to know?

What do you want to do?

****Update 5/20/2010****

His Vital Signs

HR correlates with monitor, pulse not palpable at radial.

Initial BP 78/60

AAOx3, normal mental status, just wants to make a bowel movement.

Skin - Pale, more pronounced and white from the waste down. Skin was relatively dry.

****Update 5/23/2010****

A new 12-lead ECG is captured during transport.

The patient's vital signs do not improve dramatically with IV fluids.