‘ Going to Extremes ’ Redux

LITFL: Life in the Fast Lane Medical Blog LITFL: Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Five years ago, based on a suggestion by Greg Kelly, we sought out the most extreme parameters clinicians have encountered in looking after their patients. This is the league table we have assembled so far: ParameterLevelDiagnosisSubmitted by Fluid gain between hemodialysis sessions21 LRenal failureKT CRP950 mg/LNicky Highest glucose121 mmol/LHHS/ HONKGuru Troponin I180.0 ng/mlMIWanderer CD4 count (lowest)2 cells/uLAIDSAnne pH (lowest in DKA, and survived)6.64DKAJon Ketamine infusion500mg/h for 3 hrssedated unintubated psychotic patientMinh Le Cong Sedation with no effect(1) 80mg IV midazolam, 80 mg IV haloperidol (2) 120 mg diazepam, 100 mg haloperidol(1) Agitated patient (2) IVDU(1) Duncan (2) Toby Sodium, hypernatremia212 mmol/LJames fordyce pH (lowest in any diagnosis, and survived)6.33Shaun Lactate, hyperlactemiaunrecordable, repeated with patient improvement as 30 mmol/LShaun Ethanol level (in conscious patient)0.76 g/dLAlcohol intoxicationNeil Hughes Fastest door to operation time25 minutes from triage to appendix outAppendicitisCasey Parker BUN (blood urea nitrogen)240 mg/mLRenal failureJoe Lex Urea670 mmol/LRenal failureJoe Lex Ammonia514 umol/LTorsten Behrens Hemoglobin in chronic anemia13 g/LMenorrhagiaHammer Doc Sodium, hyponatremia98 mmol/LBeer drinker's potom...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Emergency Medicine Intensive Care clinical extremes laboratory parameters pathophysiology Source Type: blogs