ASA toxicity. Altered LOC. Tachypnea.

75-year-old male who presents with altered LOC, febrile, and tachypneic. Initial differential diagnosis for altered LOC must be explored. Patient becomes hypotensive, develops CHF and is not to be tachypneic. He is found to have an elevated anion gap metabolic acidosis and primary respiratory alkalosis. Learner is expected to manage by alkalinization with sodium bicarbonate and to address glucose and electrolyte derangements.

Goals and Objectives

Educational Goal:

• General approach to altered, febrile patient.

Objectives (Medical and CRM):

• Shared mental model (summarize patient’s condition)
• Resource Allocation (use all members of team to help with obtaining more info, from EHS, family and have UC provide Pharmanet).
• Call for help ( call ICU early and poison control).
• Recognition of ASA toxicity and treatment.