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"Is that ethylene glycol or are you just happy to kill me?" Sean and Stuart go over the old ethylene-glycol-in-the-coffee routine and how to identify it.
Dr. Nordt, Sorry I will miss your talk in Columbus :( I am working an er shift the night of your talk and could not switch since I am starting trauma the following week. I will look forward to it when its taped for emrap.When you have a pt with ams, esp elderly with elevated lactate and metabolic acidosis and new onset renal failure, after we start treating for sepsis, should we be getting a repeat bmp. If so, how soon? In our ed, we tend to only get one. And unless the pt is on bipap or intubated, we are usually not repeating a blood gas in the ed. Should we be? I guess i am just asking, as if urine and chest X-ray are normal, when should these repeat tests be ordered to see if you need to start treating for possible ethylene glycol toxicity versus sepsis/meningitis/encephalitis only? Thanks.
Hey all! Great session!
I'm wondering what your thoughts are regarding serum osmolality. If I have a patient with a clinical presentation concerning for ethylene glycol by basic labs (CBC, Chem, Lactate), can I use the serum osmolality to reliably rule the diagnosis in/out?
What you do matters.