(http://www.3rbox.com/get-4-2008-3rbox_com_wwx16rhb.bmp) | Around 07:00 AM, a 39 yr old man was brought to the emergency department by an ambulance. They found him lying near the stoop of an apartment building. The paramedics were not able to obtain any history from the patient. When arrival, The patient ‘s mental status still altered and his skin is cold . his vital signs were as follows: heart rate of 38 beats p/m, blood pressure of 88/40 mm Hg, respiratory rate of 24 breaths p/ m and oral temperature of 35.4°F. His oxygen saturation could not be obtained with the pulse oximeter. At first glance, The patient appears to be a homeless, disheveled man and looks older than his chronologic age, with a faint smell of alcohol on his breath. No obvious signs of head trauma are noted. The patient is far from stupor, easy to wake up but unable to follow simple commands. His pupils are isocor with normal pupillary reflexes. Physical examination of the patients’ heart are notable for marked bradycardia and the examination of the lungs reveals a remarkable rhonchi over the right lower lung field. Laboratory values were ordered. His blood glucose level was 104 mg/dL. 1a. Mention most notable abnormalities demonstrated by the ECG? 1b. What is your diagnosis based on the answer of the first question? 2. What is the most possible etiology in this case? 3. What is the most possible complication of this diagnosis? 4. What are the treatment? |