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Tuesday, December 5, 2006
Unbelievable Happening This Morning in the ER ...............
EMS brings in a young female from her home. Patient is unresponsive and Tachycardic (Rapid Heart rate). The only info we get is that she's been "sick" for about a week. Takes no regular meds and has no allergies to meds.
One look and you can tell this kid's in trouble. She's totally not aware of her surroundings and sweating like a pig.
Why is she sweating like a pig, you ask?
BECAUSE HER TEMPERATURE (rectally) WAS 107.8 DEGREES!!
Here's the first thing I thought of when heard what the temp was -
Smell that?
That's Good 'ole Country Fried Brain Cells!
I've been doing this job for a long time now and I've only seen one other person with a temp like that. That was an elderly guy with a huge untreated brain bleed and his elevated temp wasn't really unexpected.
107.8 is NOT expected in a young female. She was obviously in Septic Shock and not compensating any longer. Here's a little info on Septic Shock and Another One Here, if you're interested.
We jumped all over her and did everything that we should have done - Lines (ended up with 3 IV's), High flow O2, Labs, Fluids (Lots of fluids), Tylenol, Ice to the vital spots, Catheter and Antibiotics (Two Different Ones) all in about an hour. We then flew her out to a big Med Center. Her temp was down to ONLY 103.5 when she left. I don't think I've ever been happy to get a temp of only 103.5.
About 6 hours later, the Med Center calls. First thing that crosses my mind is "Oh Shit. She's crumped already". I was wrong. It seems that the young lady had a bad appendix. As in it had burst. Probably yesterday. But they tell me she was alert and and answering questions appropriately and her temp was down to 100 degrees even as she went into surgery.
All I can say is - Wow. She may make it and if she does, it sounds like her brain will have some function to boot. Hopefully her Kidneys come back online and she doesn't continue into DIC or Disseminated Intravascular Coagulation as her labs indicated she was heading. Technically, there's a lot more to this story and as interesting as this shit is to me and other ER Geeks, I'll spare you the details.
Suffice to say - This was a first.