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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