A Fisherman’s Friend… or Foe?

aka Toxicology Conundrum 052 A 64 year-old male was brought in after a collapse at home. He had been sitting on the couch with his wife when she noticed that he had gone limp and was not breathing. Bystander CPR was performed for 15 minutes until ambulance crews arrived. He received 2x DC 200J shock for ventricular fibrillation, after which he had a return of spontaneous circulation, with HR 80 sinus rhythm, BP 90/60 and GCS 3. In the Emergency department he received 300mg Amiodarone, and cooling was commenced as per out of hospital cardiac arrest protocol at that time. He had a further episode of VF arrest soon after arriving in the ED, with ROSC post 1x DC shock 200J. This ECG was obtained: Click to enlarge Questions Q1. Describe and interpret the ECG. Answer and interpretation expand(document.getElementById('ddet1033429861'));expand(document.getElementById('ddetlink1033429861')) This ECG is consistent with HYPOKALAEMIA Increased amplitude and width of P wave Prolongation of PR interval T wave flattening and inversion ST depression Prominent U waves Apparent long QT: due to fusion of T and U waves Q2. What is the differential diagnosis of the cause of the ECG findings? Answer and interpretation expand(document.getElementById('ddet1057266623'));expand(document.getElementById('ddetlink1057266623')) Hypokalaemia is a serum potassium below 3.5mEq/L Can occur as a result of Decreased intake, Transcellular shift or Increased loss. An approach to determining source of Hypok...
Source: Life in the Fast Lane - Category: Emergency Medicine Doctors Authors: Tags: Clinical Case Emergency Medicine Featured Intensive Care Toxicology Toxicology Quiz cardiac arrest ECG Glycyrrhizic acidm hypokalemia laboratory results licorice liquorice Source Type: blogs