case discussion dr.venkatesh emergency on GBS

gbs

1. Dr.Kanyadari Venkatesh Emergency Resident CASE PRESENTATION

2. patient information Name:S.Nagesh Age : 28yrs Gender: male

3. chief complaints Both upperlimb and lower limb weakness H/o fallfrom chair today morning sustained truma to lowe jaw

4. history of present illness A 28yrs old male ptatient brought to ER with complants of b/l upper and lower limb weakness since 5 days,Initially pt went to local hospital and admiteed over and brought here for further mangement . No h/o fever / trauma/ vomiting /loose stools no h/o similar episodes NO known comorbes NKDA

5. Primary survey Airway: Patent, no pooling of secretions, Breathing: b/l air entry + , spo2 ; 96%on RA Circulation: peripheral pulses=, carotid pulse :present, s1s2: +, BP :140 80mm hg , HR: 103per minute

6. Disability: GCS: E4V5M6, pupils :2mm reactive,GRBS: 301mg/dl. Power of limb - RUL-3/5, RLL-3/5 LUL-3/5, LLL-3/5

7. Investigations(done outside) MRI BRAIN , MRI SPINE NCT S.ELECTROLYTES, CBP

8. Investigations revealed Initial ABG s/o sev metabolic acidosis for which 50ml NaHCO3 was given as bolus. foley’s catheterization was done to moniter end organ perfusion. pt was sent to radiological investigations with minimal norad support.