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ER Diaries : Classic case of Hypocalcemia

Classic case of Hypocalcemia 

42 year old male presented to ER with painful carpal spasm since 30min after consuming alcohol sudden in onset. No ho fever / CP/SOB/ dehydration/ headache/
Kco DM not on medication. Smoker alcoholic

Vitals BP 170/100mmHg
Grbs 153mgdl
Pr 90/min
Rr 24/min
Spo2 97% on room air
Temp 98F
Ecg LVH pattern 
Examination 
Red eyes prolly due to the influence of alcohol
Aggressive demeanour 
None of the systemic findings came positive except for
trousseau sign +
Pitting Pedal edema
 I quickly sent abg and s calcium.

S. cal was 7.8 
K was 2.7
Na also on 127ish

10% Calcium gluconate slow Iv
Slow Nacl 0.9%
Took physician opinion.
KCL he asked to start 
But then for high concentration electrolyte icu admission required.


                                                They had insurance that didn’t work in our hospital,they refused.
Discharge them against medical advice . Explaining them risk of transport, need for ICU admission. Prognosis. How easy it was to revert it and how dangerous outcome can be if ignored.
T .myoril 8mg
Anti hypertensive from my end.

So far so much!

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