[LEFT][LEFT]This patient was brought to ER on 23-11-11 by Red Crescent and no family around.
Initial Assessment was: T: 37.1, RR: 25/min.
He was comatose with GCS 6/15 and pupils were pinpoint and his skin was covered with glue plus multiple laceration. His cardiac arrest, respiratory and abdominal examination were normal.
Initial Blood works:
WBC: 8>63, Hb: 14, Plt: 399
Na: 134, K: 1.7, Creatinine: 171
Coagulation, LFT were normal
Ca: 2, Mg: 1.25, CK: 699, LDH: 220
PH: 6.86, Pco2: 76, Hco3: 12.3
Initial CT brain was acceptable and no hemorrhage or edema. Toxicology screen was sent. He was managed initially as case of sever hypokalemia and glue sniffers ? drug overdose. Electivley intubated and shifted to ICU where his condition is deteriorated and developed seizures. CT brain was repeated showed multiple bilateral hypodense area in cerebral hemisphere and brain skin in addition to brain edema. Managed according to that toxicology screen came with high Benzodiazepine level and Paracetamol but we should consider that patient on Midulazam and Paracetamol. Ethanol, Methanol, Enphetamine, Bartbiturates, CArabis, Cocaine and opiales were negatives. Patient deteriorated gradually and no improvement and on 30-11-2011 discussion between ICU and Nephrologist about his condition and brain death and it was poor prognosis with brain death but required EEG to confirm that but after stabilization on 5-12-2011 patient went into bradycardia and developed cardiac arrest. CPR was done for 30 minutes but no response and death declared at 23:49

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