Case 18 – update 2

Initial blood investigations are back.

  • Hb 84
  • plt 70
  • wcc 3.4
  • Na 136
  • K 6.5
  • urea 34.5
  • creatinine 476
  • Ca 2.31
  • albumin 26
  • ALT 47
  • ALP 67
  • Bili 27

Any further blood test needed?  immediate treatment/investigations?

Pt is catheterised with 20mls residual volume.   Fluid challenge of 500mls is given, however blood pressure fails to improve.  Repeat BP 76/52, HR 116, SATS 92% on 5L, RR20.  ITU are contacted, and will review but currently busy with another emergency.  What do you do?

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