CASE PRESENTATION. R MAHARAJ. CASE STUDY. 11 year old LM...involved in a pedestrian –vehicle accident on Koeberg Road. Taken to nearby fire station by motorist – attended to by paramedic. Initial assessment – BP 80/55, P 121, sats 82%, B/S 5 GCS –E 1, V 2, M 5
GCS –E 1, V 2, M 5
No focal signs
blood sugar 5.7
Action – osmotic effects
- rheologic effects
- free radical scavenger
suggested temp 32 – 34 degrees C.
RXH – aim for normothermia. Treat hyperthermia aggressively.
SIADH vs CEREBRAL SALT WASTING vs DIABETES INSIPIDUS
-intravascular volume normal/mildly incrd
- urine osmolality > serum osmolality
- urine sodium normal
- intravascular volume depletion – incr urea, serum protein.
- incr urine sodium
- low urine sodium