Agitated AdamYou are working in an urgent care unit. You are called to see one of the patients who was admitted with a two history of vomiting and epigastric pain. When you see him, it takes a while to get the story because he keeps wretching into a bucket. An IV line has been started to rehydrate him. His vitals are P100, BP 110/60, RR20, T37.3, SaO2 92%. He is not on any medications and has no allergies. He denies any other recreational drug use: "I'm not a junkie, doc!" he growls. The nurse points to the 2 empty bottles of Listerine Gold in his day bag. "Oh, that's just for my breath after all this vomiting," he replies.
Examination shows marked epigastric tenderness, scant bowel sounds, moderate guarding and mild rebound tenderness. Which tests would you like to perform at this point? Which are the three most useful tests? What is the most likely diagnosis? Adam is admitted to hospital. 3 days later Adam is confused.
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Map: Street Drug Guide (5)
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Review your pathway |
