Case #7

HISTORY

The patient is a 32 year old male fire fighter who presents to the ED unresponsive after being involved in extinguishing a 5 alarm factory fire. 100% oxygen was administered in the field.

PHYSICAL

• General: Unresponsive, in moderate respiratory distress
• Vitals: HR=60 RR=44 T=98.4 BP=190/110
• HEENT: NC/AT; Pupils midrange sluggish
• Soot-tinged secretions
• Lungs: Scattered rhonchi with exp wheeze
• Ht: RR S1S2, no murmurs
• Ext: +2/4 pulses
• Neuro: No focal defs, moves all 4 exts
• Skin: Ashen color, cool

DIAGNOSTIC STUDIES

• CBC: WBC=19.7 H/H=15/45 PLT=298K
• Lytes: Na=134 K=4.8 Cl=108
• Glucose: 134
• BUN/Cr: 20/1.5
• L.A.: 18
• MetHgb: 2%
• C.O. 30%

• ECG- Sinus Tachicardia

• CXR- Normal lung fields, ET tube above carina

Toxin and Discussion References