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  • CAP SIM Naeem Hughes - AAA Dissection (Student Copy)

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    1) A patient presented to the ICU with chest pain and a heart rate of 174. Despite treatment including adenosine, nitroprusside, and cardioversion, the patient's condition did not improve. 2) The patient was transferred to the ICU with ongoing chest pain, headache, and normal sinus rhythm. Vitals at transfer showed a heart rate of 90 and blood pressure of 159/90. 3) In the ICU, an arterial line was placed and nitroprusside was started at 72 mL/hr to control the patient's blood pressure which remained elevated at 170/90.

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    CAP SIM Naeem Hughes_ AAA Dissection (Student Copy) (1)

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    1) A patient presented to the ICU with chest pain and a heart rate of 174. Despite treatment including adenosine, nitroprusside, and cardioversion, the patient's condition did not improve. 2) The patient was transferred to the ICU with ongoing chest pain, headache, and normal sinus rhythm. Vitals at transfer showed a heart rate of 90 and blood pressure of 159/90. 3) In the ICU, an arterial line was placed and nitroprusside was started at 72 mL/hr to control the patient's blood pressure which remained elevated at 170/90.

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    5 views1 page

    CAP SIM Naeem Hughes - AAA Dissection (Student Copy)

    Uploaded by

    dzmtz02
    1) A patient presented to the ICU with chest pain and a heart rate of 174. Despite treatment including adenosine, nitroprusside, and cardioversion, the patient's condition did not improve. 2) The patient was transferred to the ICU with ongoing chest pain, headache, and normal sinus rhythm. Vitals at transfer showed a heart rate of 90 and blood pressure of 159/90. 3) In the ICU, an arterial line was placed and nitroprusside was started at 72 mL/hr to control the patient's blood pressure which remained elevated at 170/90.

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    of 1

    scenario start time:11:40 AM

    PT dropped off at ICU


    ViTUIS: 11:54 AM
    HR:174
    01:97 chest pain 9110

    4: 98 Doesnt think transfer was good


    BP:149181 Headache:9/10
    Pulses:normal itbilateral

    lungs:crackles bilaterally pedal 2+ bilateral

    pain:left side of chest normal grip bilateral


    skin normal

    Adenosine IUngS
    11:45 AM
    11:42 AM -> no
    change
    still in SUT Dr called at 11:59 AM
    12
    mg
    11:47 AM Nitropruside drip

    Pupils round reactive cardioversion 50 joules


    0.3 mcg/kg/min titrate

    9001 BP 120 systolic


    midazolam 3mg IV ->
    11:48Am
    called DR:11:45 AM
    pads attached 11:40 AM LBL

    Vitals 11:47 AM cardiovert delivered 11:49AM D-dimer

    P:148 HR: 89 11:51 AM Chest X-ray


    7:48 02:97
    CMP
    BP:148101
    12:18 R:18 LKMB

    BP: 142183 HR B or improved Troponin


    02: 97 4/10
    chest pain PT, PTT, INR
    normal sinus rhythm EKG

    Dr called 11:52 AM Headache B chest pain


    Transfer pt to ICU 12:03 PM
    ICU called 11:53 AM

    Vitals 11:54 AM
    HR: 90 11:03PM -> urterial line
    02:94 called
    7:98.8 Vitals 12:04 PM
    BP:159190
    7:48
    R:18
    12:04 PM P:98

    Bowels:went
    last BP:170190
    night
    R:18

    02:9H

    Nitroprusside
    72 mL/hr
    not given yet

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