‘ 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: Chris Nickson Tags: Emergency Medicine Intensive Care clinical extremes laboratory parameters pathophysiology Source Type: blogs
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