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Crit-Cases

A 67 year old male is brought to ED via ambulance an hour after an overdose of metoprolol, quantity unknown. He is delirious and not following commands. His blood pressure is 85/45. He is known to have non-insulin requiring diabetes mellitus, hypertension and peripheral vascular disease.

Answer the following questions


  • Question 1
  • Question 2
  • Question 3
  • Question 4
  • Question 5

Outline the features of this ECG. Explain the patientÂ’s mental status

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He deteriorates, has a brief grand mal seizure and requires intubation. His heart rate falls to 25 and his blood pressure is unrecordable (very faint slow pulse felt). Describe your management

You decide to pace him transvenously. List 5 immediate and 5 short term complications of transvenous pacing

As he improves 2 days later, he develops a tense calf. The following blood results are obtained. Describe the abnormalities. Describe your management

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He is recovering 9 days later, and remains on the haemofilter.  His temperature is 37.6 degrees.  A blood culture is reported as follows:

What is the significance of this result?  What would you do?

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