Round 8 (Fall)

CAUTION: THESE NOTES CONTAIN SPOILERS!!!











Case Introduction











EMS brings in an elderly man who has fallen…











Initial Vitals











* Temp 98.6* HR 58* RR 16* BP 105/60* 99%











Critical Actions











* Treat the patient’s pain* Consult orthopedics for a hip fracture* Obtain an EKG* Treat Severe Hyperkalemia* Consult nephrology for dialysis











Final Diagnosis











Ground level fall resulting in hip fracture, missed dialysis, and severe hyperkalemia











Tips and Tricks











Patient’s will frequently have more than one final diagnosis. Do not prematurely close an the initial, obvious, diagnosis.











A man can have as many diseases as he damn well pleases! Hickam’s dictum











Additional Reading











* Basic approach to hyperkalemia (EM Clerkship)* EKG manifestations of hyperkalaemia (LITFL)