Multiprofessional Critical Care Review: Adult 2024 (MCCRCA24ON)-06_Case Studies

06_Case Studies_Toxicology

Pdf Summary

A 28-year-old man with a single gunshot wound to the chest presented with confusion and agitation, along with an elevated blood alcohol level and anion gap metabolic acidosis. The patient was treated with lorazepam and eventually intubated due to a decrease in oxygen saturation. The recommended initial analgesia/sedation regimen was fentanyl IV as needed and propofol infusion. The patient later exhibited high triglycerides and lactate levels, indicating a potential diagnosis of propofol infusion syndrome(PRIS). This was supported by the absence of arrhythmias. The patient's condition improved with cessation of propofol therapy. The document emphasizes the importance of tailored sedation protocols and monitoring for complications in critically ill patients with complex medical histories.

Keywords

gunshot wound

chest injury

confusion

agitation

metabolic acidosis

lorazepam

intubation

propofol infusion syndrome

sedation protocols

critical care

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