Clinical Case 3
A 35-year-old male is brought into resus as a standby call. On arrival the patient appears quite unwell;
- Heart rate is 130 bpm
- Respiratory rate 30 bpm
- Blood pressure 94/58 mmHg
- Temperature 35.6°C
- SaO2 99% with 15 L via a non-rebreather mask
- CRT 2.5 sec
- Cool at the peripheries
Examination reveals bibasal chest dullness, no evidence of peripheral oedema and a mildly tender abdomen, which does not appear peritonitic. The patient appears to weigh approximately 100 kg.
You suspect pancreatitis and start resuscitation. Initial bloods show pH 7.28, HCO3 19, pCO2 3.4, Lac 3.6 and PO2 15.4, WCC of 18.0, urea of 22, creatinine of 168, CRP 160 and amylase of 1243.