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Mon Jun 27 06:06:53 BST 2005

Lee

Acute hyperkalemic cardiac arrest after inability to excrete the K from Rhabdo induced nephropathy??? Will just show up as "pale kidneys" on autopsy! What was the serum K?

Tim
Dr T C Hardcastle
M.B.,Ch.B.(Stell); M.Med(Chir); FCS(SA)
General Surgeon (Trauma and ICU)
ATLS and DSTC instructor
Intern program Coordinator: Surgery
Program Manager: Emergency Medicine (U.S.)
Operational Head: Diana Princess of Wales Trauma Unit
Department of Surgery Room 4064
Tygerberg Hospital / University of Stellenbosch
PO Box 19063
Tygerberg 7505
Western Cape
South Africa

2 Lorient Close
Vredekloof, Brackenfell
7560, Western Cape,
South Africa
e-mail: tch at sun.ac.za
Cell: +27824681615
Office: +27219389281 or 4911 pager 0302
Home: +27219813098

-----Original Message-----
From: Phil Hoffman [mailto:phoffman at charlevoixmfg.com]
Sent: Saturday, June 25, 2005 5:20 PM
To: 'Trauma & Critical Care mailing list'
Subject: RE: case

Lee,

I think I have figured out most of the TLAs (three letter acronyms) in your
missive, but have no idea what "wet" is, nor what a banana bag could be.

Phil
EMTP

-----Original Message-----
From: Lee Reed [mailto:creedyrniam at sbcglobal.net] 
Sent: Saturday, June 25, 2005 4:47 AM
To: trauma-list at trauma.org
Subject: case

27 year old AAm brought in by police and EMS, who state use of 'wet;...pt is
tachycardic and hypotensive upon arrival, but AOX3...tox is only positive
for marijuiana, alcohol negative....pt sleeps, is given banana
bag...continues to  be arousable...initial labs show rhabdo, not uncommon
with wet...draw repeat labs, and all of a sudden patient codes...repeat
chest pain panel drawn just prior to arrest comes back higher than
inital...patient ends up dying...autopsy shows nothing abnormal, still
awaiting extensive tox screen...we had thought that perhaps there was
underlying cardiac abnormality, but that was ruled out....question is mostly
to those in major urban centers...what the hell do you think happened here?
my guess is GHB or other designer drug...
Lee
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