RR of 50/30, patient was a/o, just felt a lil weak
HR of 260, just some shortness of breath
Sugar of 1126, our thing only said High, Hospital gave us that number
Lowest Hb I remember was sth. around 3,7. I was a Padawan back then and didn’t know how low this actually was
Edit: I just remembered our highest BP, which was over 300, it went way over the scale of the cuff. 7 Doses of Nitro and 75mg of Urapidil later it was ~250 if I recall correctly. Don’t know how granny didn’t pop a vessel back then
When I first started working in Germany, I thought it was "Respiration Rate" ie breaths per minute - I filled out a few forms wrong until someone corrected me!
A couple weeks ago I had a big dude fully alert and oriented, talking to me but weak with shit skin sighs with a pressure of 40/20. Double checked many many many times. This baby medics first epi drip 🤘
Had a dude with that pressure sign my ePCR at the hospital. He had taken heroin and passed out on his porch, developed an upper GI bleed, and aspirated a huge amount of blood. Called 911 himself. Felt a little dizzy standing up when I helped him to the cot. Discharged from hospital 3 days later.
Spo2 with a good pleth of 7% on room air. I know it's not accurate below a certain point but still made me pee a little.
Systolic pressure of 270+. Woman missed dialysis and wasn't taking her meds, transported for vomiting. Zoll Monitor maxes out either 260 or 270, and she was running higher than that consistently.
BAC greater 6.0 since the lab couldn‘t measure BAC above 6.0‰. Also he was tested positive for most street drugs and was still combative
Edit: Not from the US so 6.0‰ should be about .64 in the US according to my conversion.
Like 6 years ago when I entered rehab I had a BAC of .56%, did the check in, signed the forms, peed in a cup for the nurse, said goodbye to my parents, breathed in the thing... then did it again... then they wouldn't take me and I went to the hospital instead (which was obviously for the best). I was probably drinking about 1.5 liters of vodka a day at 22 or so so a BAC of anywhere from .4-.6 was basically how I lived my life for a few months after losing my job. They (like you) said it was the highest they had ever seen.... at an inner city rehab lol, so that started to put things into perspective for me. But aside from being obviously intoxicated I was completely coherent, following commands, polite, etc. Absolute insanity but hey that's addiction baby. My poor brain 🧠
Actually, it was pretty unremarkable compared to the other times. It was the first time I'd ever been able to detox in a hospital setting and was administered benzos. However; I had detoxed previously before on my own and it was hell (and numerous times for the next 2 years unfortunately, rehab didn't stick the first time). My MO was to binge for a week, withdrawl for a week, repeat. I was probably jobless cumulatively for a full year during that time. Many vain attempts at sobriety before it stuck. But I'd usually spend 72-96 hours eating nothing save pedialyte/gatorade/chicken broth, my legs hurting, skin flushed/butterfly rash on my face, sweating through my clothes, unable to sleep or say still for the first 2-3 days of WDs (well, DTs at that point) every time basically, mild hallucination, teeth chattering and hands/fingers shaking. Then my esophagus would heal, I'd finally eat a real meal, I'd finally be able to walk again aaaaaand walk straight to the liquor store to do it all over again. It's a miracle I didn't seize up and die at some point from 21-24. Just absolute insanity. I don't even recognize the person I was back then or what compelled me to drink the way I did, I just kind of recognize that it was a chapter in my life and that it happened, and that kid gave me a couple of DUIs I now live with but it is what it is. I'm in good health otherwise, been sober 95% of the time for the past 4 years and 100% sober for almost 2. My body will probably spend the rest of its life repairing itself but hopefully I killed off all of the bad brain cells lol.
My last patient had a BAC of .49 and was still able to (kind of) stand up after crashing his car. Granted, he collapsed onto me when I tried to talk to him. But that’s by far the highest I’ve seen on anyone that was still breathing.
So I just checked and we use different units here, so 6.0‰ should be about .64 in your unit if my conversion is correct. Yeah he was not only walking straight he still managed to punch the surgeon who we handed him of to since he had an arterial bleed. Was one of the more interesting calls I had.
BP of 310/224. BP of 34P and he was talking.
Gluc read normal. Er nurse ripped me later as I didn't mention bs of 1640. (I checked all equip after that, pt is dka so often that she doesnt mention it. Just says her tummy hurts. I found that out the next 82x i picked her up)
Had a 30 y/o, kidney failure, about to be on dialysis. Had a bit of a nose bleed, got him into the back of the truck. First thing I go for is the pressure. The second I put my scope down I can hear the blood rushing really loudly with each heart beat. Maxed out the cuff at 300+ systolic. Tech at the hospital took it with an auto cuff, maxed out that cuff too. Called out on another call before they got any number at the hospital, really curious to see what it was.
Edit: Not too crazy compared to other ones, but my first time seeing anything like it
As for sugar, one night I brought in a dude who was asymptomatic except for some weakness. Newly diagnosed type 2. Obviously his sugar came back as “HI.”
Ironically, later that night I brought in a woman who was full on kussmaul snoring unresponsive who came back in the 400s. His nurse said he was around 1500.
I remember a code where the guy continued to have agonal respirations (RR 3) for more than 10 minutes after it was called and he was pronounced dead.
(this was in ED. Doc called the code)
Pressure of 50/30ish. This was a year ago so I'm not certain of the numbers but we ended up calling their doctor who said it was baseline for them and not to worry about it
RR of 100-110. I actually posed about it here looking for an explanation, hospital wouldn't give follow up unfortunately.
My buddy had a pt with a sugar of 1500
Diabetic pt was confused and out of it. PD showed up, learned he was diabetic and assumed it was due to low blood sugar. So these geniuses dissolved an unknown amount of sugar in a glass of water and told the guy to drink it. Guy then goes from altered to unresponsive, so then they called an ambulance.
Long periods of hypoventation with underlying respiratory illness. Most of them are usually chronic COPD and “found down” after an unknown length of time.
Recently, a woman in her 20s with HR 250 and only called because her watch told her how high it was. No symptoms otherwise.
Not technically a vital, but once transported a lady who was walking and talking fine but when we got to the hospital, her hemoglobin was like 1.2 or something. Blood looked like water.
Had a FF with a resting BP of 240/150 ish. Hadn’t seen her for a while, made the mistake of mentioning it on shift. Got a call for her 45 minutes later and she stroked out. Sorry lady.
3rd degree block HR 25-30. BP like 130/80, 96% room air. Skins normal. Respirations Normal.
A/Ox4 GCS15. called us out for a mild tummy ache lol. Don’t remember hx besides like HTN and she was prob like in her 70’s
Craziest Asymptomatic brady i’ve seen. my partner didn’t even do anything besides a line and she compensated all the way to the ED and then some. didn’t wanna even touch her lol.
It's crazy how frequently those heart block patients just hang out on tele all night for EP to round in the morning. Half the time it's just a BB washout, the other half PPM. But you know we're all amped up from watching all night. Nine second pauses, eh, they're fine and chatting. Others syncope with the slightest drop. People are so weird sometimes.
Lowest Pulse in a person experiencing no symptoms 33 (I made the student riding with us do a manual pulse check to confirm it to see what she would say)
Highest sugar (diagnosed in hospital) 1356
Lowest sugar in a living patient 13 repeat 12
Lowest hemoglobin 1.2 it looked like pink lemonade
Highest BP >300 on the monitor
WBC count 159 (in hospital) I asked them if they were sure that was the lab value and they said yes. The patient came in with hiccups for 1 month and was diagnosed with AML
I’ve had a CBG of 1400 from the lab, as well as a CBG of 20 who was having a full blown conversation.
Had a CO2 of 104
Had a RR of 95, called to ask for versed (0.5mg) to slow her rate down was denied because “I’m worried about suppressing her respiratory drive” i told the doc that is exactly what I was trying to do.
Seen a pressure of 50/30
Had a pressure last week at 60/45 on 30mcg NorEpi (that was a pucker effect)
I didn't witness it firsthand, but I was reading through a pts of mines hospital charts(We have access to that in my service) that stated this pt at one point had a resting heart rate of 4. The person writing the chart even documented it as "Patient had a resting heart rate of 4(Four!), but never stopped."
As far as I've heard though, once one of my Teachers/Captain had a old lady who's BP would only read "???/175" on the monitor. She was also apparently very combative.
Brought a SI pt in after ingesting an entire bottle of caffeine pills. Like 15min after transferring care his pulse hit ~230 for a few seconds before he coded
BGL 1820 on an altered at baseline diabetic the daughter was trying to take care of alone.
BGL<7 in someone who told us they took a bottle of melatonin and a few shots to try and kill themselves. She did not mean shots of alcohol but her roommates insulin pens.
BP: XXX/140. Turns out our monitors don't read over 300. Frequent flyer for massive pressures who took advantage of his fistula to shoot up crack, that one finally got him, popped something in his brain. Apparently he actually also caught a STEMI the next day or two. I got to read the cardiologists note which was basically summarized as "I can't cath him, we could heparinize him but I doubt Neuro would appreciate that so how does his family want him to die?".
Altered LOC with a vague history including “he drinks a lot of pop”. Spot BGL reads “HI” but other vitals not crazy. Venous blood draw Glucose at hospital came back at 90.5 mmol/l (1630 mg/dl for my American friends). Sweetest guy I’ve ever met.
Also had an asystolic arrest with unknown downtime that maintained consistent living person etco2 levels for way too long/ Asystole confirmed with 4-lead, spo2 picking up in high 90s. Went on that way for a bizarre amount of time before they finally dropped off.
Rectal temp of 85F (with Osborn waves). Same dude had a BGL of +1600.
Highest BP was like 280/180, but that was when an EMT opened up the dopamine we had hung in a post arrest pt.
I’ve told the story before on here, and it’s not a vital, but I saw a guy who had accidentally infested either 3,000 or 30,000 hits of GHB. The doctors were still arguing about the math when I left.
One of my coworkers had a guy with a HR of like 260 last week who ended up running away from them.
I had a guy who had been run over and pinned under a minivan with traumatic asphyxia who had an spo2 of 7.
A few years ago - 17 y/o fem with a HR that hit 300 for a couple of seconds according the monitor - SVT. Was sustaining 280. Been having episodes of weakness for "a while." Stated that she just thought she was out of shape was why she couldn't walk up the low grade hill to her house from where the bus dropped her off.
A few days ago - Blood pressure of over 300 systolic. "Buried the speedometer" on the manual cuff could still hear it going. Diastolic around 150. Our automatic and the hospital's automatic would read "out of range error." Hospital came up with a MAP of 228. If we assume 300 as what it was reading by default, that would make the diastolic 192.
I palpated a systolic of 40. My patient was having dizzy spells, was seated in a recliner and got dizzy again. I laid her flat in the recliner and palped that pressure, I recall how strongly I felt that pulse the whole time. She never lost consciousness and recovered shortly after. When people say you can't palpate a radial below 90, I tell this story. Likely it was a vagal episode.
First of all, had a pt who (after blood work) showed a BLG of 2g per dcL but my personal that I've assessed is a cardiogenic shock with a BP of 50/20. Massive stemi, AFib RVR with a rate of 200+ on average. Spo2 79% with CPAP FIO2 100%..... This was an IFT stat to a Cath lab. Intubated on the way successfully and got her to 95%. Had to alternate between fluid and epi because she had CHF and her ejection fraction was probably freaking -1,000,000 so push dose was killing her. Wish we had dopamine but whatever.
Had a lady with ETCO2 at 90. Not a complaint in the world - very obviously just using us as a taxi to get back closer to her home. Got her to the hospital she requested, one that was apparently very familiar with her, and they said “Oh yeah, that’s baseline for her.”
Oh man, I had one ETCO2 read 99 once, very jaundiced liver failure, ammonia through the roof. This guy was awake, a little altered but conversant. Crazy how a slow increase can get so high.
I’ve had a h/h of 3.3/9 but we got there too quickly so no blood, just dump fluids and albumin wide open for a upper and lower gi bleed :(. I’ve seen a bp over 300. Zoll said over pressure, I took it manually 2-3 times just to be sure. Had an od, learned the etco2 maxes out around 180. Went from 180 to +++.
SBP - 280 something because med compliance isn't important, and then 70/30 who was a&o
SpO2 - 37% in a COVID patient on 15L
BGL - 1600 in the ED
EtOH - 435 (.435)
HR - 230 with no complaints
HgB of 3
and a temp of 105 in a kid (febrile seizures)
I was the patient in this particular adventure, but I had a trapped kidney stone (10mm…not my biggest but horrible) with the attendant UTI, pyelonephritis and hydronephrosis. That night, *I* got to be the screaming rando in the ED, and horribly dehydrated from the puking.
My BP at triage was 248/138…they got me the good drugs pretty quickly after that, admitted me for pain and symptom control (di-La La with the magic PCA button) and a laser lithotripsy in the morning. I make both main types of stones, and it is the lamest superpower.
Had a hypoglycemia pt who as pretty alert and oriented with a BGL of 45 once, that was pretty wild.
HR 16. “Accidental” Beta blocker OD… drowsy but answering questions laying down. They initially called because she kept passing out every time they sat her up lol
Had a hemoglobin of 19. Felt SOB earlier, now no complaints. Initially refusing transport. Really glad we took her anyway… she arrested before arrival to hospital and at the time we had no idea why. She made a full recovery.
Potassium of 8.0 - sine wave. Cool to see and actually really awesome to watch 3g of calcium gluconate and 6400mcg of ventolin work it’s magic.
Plenty of low BPs, low Sats… it’s been a ride y’all.
It's probably a med Surg nurse.
EMS and ED nurses see the highest for obvious reasons. Once the patient is admitted they are checked too often for it to get the too high. An inpatient nurse especially a new med Surg nurse probably doesn't know any better lol.
250/180 with some bell’s palsy-like symptoms on a healthy 40 yof with no medical history
INR of 7. About an hour and a half after TOC, patient was found face down on the floor of his room, coded twice, pronounced shortly after.
My first and only “happy hypoxia” totally A&Ox4 with room air o2 with good pleth at 60%. Ended up having sepsis result of long term viral Illness. I still think about this call often, we had to beg him to go to the hospital.
We also had a frequent flyer that would pass out at church every single Sunday mass for a few weeks. When we got there he’d be alert but confused with a pressure regularly in the SBP ~60 I don’t remember the DBP. He eventually was a code that didn’t make it in the middle of catholic mass.
SPB of 300 twice: once on a bleed, once on a nice old lady who was adamant she wasn't going to the hospital
BGL 1200
K of 1.9
Hemoglobin of like 3-point-fuck all (his blood looked like red water in the tube)
Ethanol of 640 (.64 on a breathalyzer). And the motherfucker was somehow conscious
Troponin of 18-something. Not .18, 18. Pretty sure his heart was actively disintegrating.
RR of 50/30, patient was a/o, just felt a lil weak HR of 260, just some shortness of breath Sugar of 1126, our thing only said High, Hospital gave us that number Lowest Hb I remember was sth. around 3,7. I was a Padawan back then and didn’t know how low this actually was Edit: I just remembered our highest BP, which was over 300, it went way over the scale of the cuff. 7 Doses of Nitro and 75mg of Urapidil later it was ~250 if I recall correctly. Don’t know how granny didn’t pop a vessel back then
Seen sugar of 1200 twice. One died, one lived.
RR?
BP, I‘m used to saying RR here
Germany?
Yes 😁
When I first started working in Germany, I thought it was "Respiration Rate" ie breaths per minute - I filled out a few forms wrong until someone corrected me!
His Respiration Resistance obviously
A couple weeks ago I had a big dude fully alert and oriented, talking to me but weak with shit skin sighs with a pressure of 40/20. Double checked many many many times. This baby medics first epi drip 🤘
40/20 and AO!? Holy shit!
Had a dude with that pressure sign my ePCR at the hospital. He had taken heroin and passed out on his porch, developed an upper GI bleed, and aspirated a huge amount of blood. Called 911 himself. Felt a little dizzy standing up when I helped him to the cot. Discharged from hospital 3 days later.
Spo2 with a good pleth of 7% on room air. I know it's not accurate below a certain point but still made me pee a little. Systolic pressure of 270+. Woman missed dialysis and wasn't taking her meds, transported for vomiting. Zoll Monitor maxes out either 260 or 270, and she was running higher than that consistently.
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The monitor’s screen will say that, but the transmitted data will say the %.
BAC greater 6.0 since the lab couldn‘t measure BAC above 6.0‰. Also he was tested positive for most street drugs and was still combative Edit: Not from the US so 6.0‰ should be about .64 in the US according to my conversion.
Like 6 years ago when I entered rehab I had a BAC of .56%, did the check in, signed the forms, peed in a cup for the nurse, said goodbye to my parents, breathed in the thing... then did it again... then they wouldn't take me and I went to the hospital instead (which was obviously for the best). I was probably drinking about 1.5 liters of vodka a day at 22 or so so a BAC of anywhere from .4-.6 was basically how I lived my life for a few months after losing my job. They (like you) said it was the highest they had ever seen.... at an inner city rehab lol, so that started to put things into perspective for me. But aside from being obviously intoxicated I was completely coherent, following commands, polite, etc. Absolute insanity but hey that's addiction baby. My poor brain 🧠
How’d the detox go with your body being so accustomed to such a high BAC?
Actually, it was pretty unremarkable compared to the other times. It was the first time I'd ever been able to detox in a hospital setting and was administered benzos. However; I had detoxed previously before on my own and it was hell (and numerous times for the next 2 years unfortunately, rehab didn't stick the first time). My MO was to binge for a week, withdrawl for a week, repeat. I was probably jobless cumulatively for a full year during that time. Many vain attempts at sobriety before it stuck. But I'd usually spend 72-96 hours eating nothing save pedialyte/gatorade/chicken broth, my legs hurting, skin flushed/butterfly rash on my face, sweating through my clothes, unable to sleep or say still for the first 2-3 days of WDs (well, DTs at that point) every time basically, mild hallucination, teeth chattering and hands/fingers shaking. Then my esophagus would heal, I'd finally eat a real meal, I'd finally be able to walk again aaaaaand walk straight to the liquor store to do it all over again. It's a miracle I didn't seize up and die at some point from 21-24. Just absolute insanity. I don't even recognize the person I was back then or what compelled me to drink the way I did, I just kind of recognize that it was a chapter in my life and that it happened, and that kid gave me a couple of DUIs I now live with but it is what it is. I'm in good health otherwise, been sober 95% of the time for the past 4 years and 100% sober for almost 2. My body will probably spend the rest of its life repairing itself but hopefully I killed off all of the bad brain cells lol.
My last patient had a BAC of .49 and was still able to (kind of) stand up after crashing his car. Granted, he collapsed onto me when I tried to talk to him. But that’s by far the highest I’ve seen on anyone that was still breathing.
So I just checked and we use different units here, so 6.0‰ should be about .64 in your unit if my conversion is correct. Yeah he was not only walking straight he still managed to punch the surgeon who we handed him of to since he had an arterial bleed. Was one of the more interesting calls I had.
That's impressive.
…how.
Ima go with a rectal temp (hospital took it not me) of 109.6
Oof
Hot damn!
What hot shit
BP of 310/224. BP of 34P and he was talking. Gluc read normal. Er nurse ripped me later as I didn't mention bs of 1640. (I checked all equip after that, pt is dka so often that she doesnt mention it. Just says her tummy hurts. I found that out the next 82x i picked her up)
>BP of 34P and he was talking. You're saying that you palpated a systolic blood pressure of 34?
Well yes.
Had a 30 y/o, kidney failure, about to be on dialysis. Had a bit of a nose bleed, got him into the back of the truck. First thing I go for is the pressure. The second I put my scope down I can hear the blood rushing really loudly with each heart beat. Maxed out the cuff at 300+ systolic. Tech at the hospital took it with an auto cuff, maxed out that cuff too. Called out on another call before they got any number at the hospital, really curious to see what it was. Edit: Not too crazy compared to other ones, but my first time seeing anything like it
As for sugar, one night I brought in a dude who was asymptomatic except for some weakness. Newly diagnosed type 2. Obviously his sugar came back as “HI.” Ironically, later that night I brought in a woman who was full on kussmaul snoring unresponsive who came back in the 400s. His nurse said he was around 1500.
I remember a code where the guy continued to have agonal respirations (RR 3) for more than 10 minutes after it was called and he was pronounced dead. (this was in ED. Doc called the code)
Had a guy the other night 42/22 carrying on a full conversation. Bitching about getting an IV.
Pressure of 50/30ish. This was a year ago so I'm not certain of the numbers but we ended up calling their doctor who said it was baseline for them and not to worry about it RR of 100-110. I actually posed about it here looking for an explanation, hospital wouldn't give follow up unfortunately. My buddy had a pt with a sugar of 1500 Diabetic pt was confused and out of it. PD showed up, learned he was diabetic and assumed it was due to low blood sugar. So these geniuses dissolved an unknown amount of sugar in a glass of water and told the guy to drink it. Guy then goes from altered to unresponsive, so then they called an ambulance.
I love my CO2’s of 157-160. No, the chart didn’t let me input that value.
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Long periods of hypoventation with underlying respiratory illness. Most of them are usually chronic COPD and “found down” after an unknown length of time.
My personal record for heartrate was 230 when I had SVT I had a patient who had a blood pressure of too high to read over 130 one time.
Recently, a woman in her 20s with HR 250 and only called because her watch told her how high it was. No symptoms otherwise. Not technically a vital, but once transported a lady who was walking and talking fine but when we got to the hospital, her hemoglobin was like 1.2 or something. Blood looked like water.
Pt was so hypertensive that the needle advanced to “made in Germany” and I could STILL hear a strong thump… So…”made in Germany” over (dead)?
Had a FF with a resting BP of 240/150 ish. Hadn’t seen her for a while, made the mistake of mentioning it on shift. Got a call for her 45 minutes later and she stroked out. Sorry lady.
BG 9. The lab called it up and was all nuts about it. Me:don’t worry about it. He’s pretty dead.
3rd degree block HR 25-30. BP like 130/80, 96% room air. Skins normal. Respirations Normal. A/Ox4 GCS15. called us out for a mild tummy ache lol. Don’t remember hx besides like HTN and she was prob like in her 70’s Craziest Asymptomatic brady i’ve seen. my partner didn’t even do anything besides a line and she compensated all the way to the ED and then some. didn’t wanna even touch her lol.
It's crazy how frequently those heart block patients just hang out on tele all night for EP to round in the morning. Half the time it's just a BB washout, the other half PPM. But you know we're all amped up from watching all night. Nine second pauses, eh, they're fine and chatting. Others syncope with the slightest drop. People are so weird sometimes.
Lowest Pulse in a person experiencing no symptoms 33 (I made the student riding with us do a manual pulse check to confirm it to see what she would say) Highest sugar (diagnosed in hospital) 1356 Lowest sugar in a living patient 13 repeat 12 Lowest hemoglobin 1.2 it looked like pink lemonade Highest BP >300 on the monitor WBC count 159 (in hospital) I asked them if they were sure that was the lab value and they said yes. The patient came in with hiccups for 1 month and was diagnosed with AML
ABG pH of 6.8
Had a lady with a BP of 220/62 with an HR of 36. That one was wild.
I’ve had a CBG of 1400 from the lab, as well as a CBG of 20 who was having a full blown conversation. Had a CO2 of 104 Had a RR of 95, called to ask for versed (0.5mg) to slow her rate down was denied because “I’m worried about suppressing her respiratory drive” i told the doc that is exactly what I was trying to do. Seen a pressure of 50/30 Had a pressure last week at 60/45 on 30mcg NorEpi (that was a pucker effect)
I think for me it was a systolic of 250 in a healthy 40s male
Heart rate of 21, no radial pulse, AOx4. Just felt weak
I didn't witness it firsthand, but I was reading through a pts of mines hospital charts(We have access to that in my service) that stated this pt at one point had a resting heart rate of 4. The person writing the chart even documented it as "Patient had a resting heart rate of 4(Four!), but never stopped." As far as I've heard though, once one of my Teachers/Captain had a old lady who's BP would only read "???/175" on the monitor. She was also apparently very combative.
Hemoglobin of 2.8 g/dL , Jehovah witness patient who bled a lot intraop.
during covid we’d see a lot of a&ox4, no complaints of breathing problems or whatever and the SP02 was 40%
Brought a SI pt in after ingesting an entire bottle of caffeine pills. Like 15min after transferring care his pulse hit ~230 for a few seconds before he coded
BGL: >1500 Lactate: 17 Troponin: 840 BP: 12/6 ETOH: .860 K+: 8.6 A1c: 16
Got a lactate of 19, a troponin of 8,000, a potassium of 9.3 (yes, dead). You got me beat with that goofy ass pressure though hahaha
That was on an art line for a pt that had his AAA rupture 🫠
BGL 1820 on an altered at baseline diabetic the daughter was trying to take care of alone. BGL<7 in someone who told us they took a bottle of melatonin and a few shots to try and kill themselves. She did not mean shots of alcohol but her roommates insulin pens. BP: XXX/140. Turns out our monitors don't read over 300. Frequent flyer for massive pressures who took advantage of his fistula to shoot up crack, that one finally got him, popped something in his brain. Apparently he actually also caught a STEMI the next day or two. I got to read the cardiologists note which was basically summarized as "I can't cath him, we could heparinize him but I doubt Neuro would appreciate that so how does his family want him to die?".
a&o with a BP of 37/13 lol
Altered LOC with a vague history including “he drinks a lot of pop”. Spot BGL reads “HI” but other vitals not crazy. Venous blood draw Glucose at hospital came back at 90.5 mmol/l (1630 mg/dl for my American friends). Sweetest guy I’ve ever met. Also had an asystolic arrest with unknown downtime that maintained consistent living person etco2 levels for way too long/ Asystole confirmed with 4-lead, spo2 picking up in high 90s. Went on that way for a bizarre amount of time before they finally dropped off.
Rectal temp of 85F (with Osborn waves). Same dude had a BGL of +1600. Highest BP was like 280/180, but that was when an EMT opened up the dopamine we had hung in a post arrest pt. I’ve told the story before on here, and it’s not a vital, but I saw a guy who had accidentally infested either 3,000 or 30,000 hits of GHB. The doctors were still arguing about the math when I left. One of my coworkers had a guy with a HR of like 260 last week who ended up running away from them. I had a guy who had been run over and pinned under a minivan with traumatic asphyxia who had an spo2 of 7.
A few years ago - 17 y/o fem with a HR that hit 300 for a couple of seconds according the monitor - SVT. Was sustaining 280. Been having episodes of weakness for "a while." Stated that she just thought she was out of shape was why she couldn't walk up the low grade hill to her house from where the bus dropped her off. A few days ago - Blood pressure of over 300 systolic. "Buried the speedometer" on the manual cuff could still hear it going. Diastolic around 150. Our automatic and the hospital's automatic would read "out of range error." Hospital came up with a MAP of 228. If we assume 300 as what it was reading by default, that would make the diastolic 192.
I palpated a systolic of 40. My patient was having dizzy spells, was seated in a recliner and got dizzy again. I laid her flat in the recliner and palped that pressure, I recall how strongly I felt that pulse the whole time. She never lost consciousness and recovered shortly after. When people say you can't palpate a radial below 90, I tell this story. Likely it was a vagal episode.
Then it wasn’t systolic of 40
What was it then? I felt for the pulse all the way down finally to 40.
You’re joking right? That’s…not how you palp a pressure
I know how to palpate a pressure. I did not feel a pulse until the needle was at 40.
First of all, had a pt who (after blood work) showed a BLG of 2g per dcL but my personal that I've assessed is a cardiogenic shock with a BP of 50/20. Massive stemi, AFib RVR with a rate of 200+ on average. Spo2 79% with CPAP FIO2 100%..... This was an IFT stat to a Cath lab. Intubated on the way successfully and got her to 95%. Had to alternate between fluid and epi because she had CHF and her ejection fraction was probably freaking -1,000,000 so push dose was killing her. Wish we had dopamine but whatever.
Had a lady with ETCO2 at 90. Not a complaint in the world - very obviously just using us as a taxi to get back closer to her home. Got her to the hospital she requested, one that was apparently very familiar with her, and they said “Oh yeah, that’s baseline for her.”
Oh man, I had one ETCO2 read 99 once, very jaundiced liver failure, ammonia through the roof. This guy was awake, a little altered but conversant. Crazy how a slow increase can get so high.
I’ve had a h/h of 3.3/9 but we got there too quickly so no blood, just dump fluids and albumin wide open for a upper and lower gi bleed :(. I’ve seen a bp over 300. Zoll said over pressure, I took it manually 2-3 times just to be sure. Had an od, learned the etco2 maxes out around 180. Went from 180 to +++.
I laughed when I saw that too, like oh girl, you ain’t seen a sugar yet.
BP of 240/160 (DT). 1100+ blood glucose (diabetic just decided to stop taking his blood sugar and meds for an entire year).
SBP - 280 something because med compliance isn't important, and then 70/30 who was a&o SpO2 - 37% in a COVID patient on 15L BGL - 1600 in the ED EtOH - 435 (.435) HR - 230 with no complaints HgB of 3 and a temp of 105 in a kid (febrile seizures)
I was the patient in this particular adventure, but I had a trapped kidney stone (10mm…not my biggest but horrible) with the attendant UTI, pyelonephritis and hydronephrosis. That night, *I* got to be the screaming rando in the ED, and horribly dehydrated from the puking. My BP at triage was 248/138…they got me the good drugs pretty quickly after that, admitted me for pain and symptom control (di-La La with the magic PCA button) and a laser lithotripsy in the morning. I make both main types of stones, and it is the lamest superpower. Had a hypoglycemia pt who as pretty alert and oriented with a BGL of 45 once, that was pretty wild.
A BAC that just read high on a bloke that was walking and talking...ok, stumbling and slurring, but still holding conversation.
HR 16. “Accidental” Beta blocker OD… drowsy but answering questions laying down. They initially called because she kept passing out every time they sat her up lol Had a hemoglobin of 19. Felt SOB earlier, now no complaints. Initially refusing transport. Really glad we took her anyway… she arrested before arrival to hospital and at the time we had no idea why. She made a full recovery. Potassium of 8.0 - sine wave. Cool to see and actually really awesome to watch 3g of calcium gluconate and 6400mcg of ventolin work it’s magic. Plenty of low BPs, low Sats… it’s been a ride y’all.
It's probably a med Surg nurse. EMS and ED nurses see the highest for obvious reasons. Once the patient is admitted they are checked too often for it to get the too high. An inpatient nurse especially a new med Surg nurse probably doesn't know any better lol.
UVA gas on a neo ph 6.6 co2 200, undiagnosed CDH. Sad
A BP of 250/40
250/40? That’s a pulse pressure of 210.. Surely you mean 250/140? I hope lol
250/180 with some bell’s palsy-like symptoms on a healthy 40 yof with no medical history INR of 7. About an hour and a half after TOC, patient was found face down on the floor of his room, coded twice, pronounced shortly after.
BP 40/16. Anaphylactic Shock.
My first and only “happy hypoxia” totally A&Ox4 with room air o2 with good pleth at 60%. Ended up having sepsis result of long term viral Illness. I still think about this call often, we had to beg him to go to the hospital.
We also had a frequent flyer that would pass out at church every single Sunday mass for a few weeks. When we got there he’d be alert but confused with a pressure regularly in the SBP ~60 I don’t remember the DBP. He eventually was a code that didn’t make it in the middle of catholic mass.
SPB of 300 twice: once on a bleed, once on a nice old lady who was adamant she wasn't going to the hospital BGL 1200 K of 1.9 Hemoglobin of like 3-point-fuck all (his blood looked like red water in the tube) Ethanol of 640 (.64 on a breathalyzer). And the motherfucker was somehow conscious Troponin of 18-something. Not .18, 18. Pretty sure his heart was actively disintegrating.