MedBugs: SAQ #608

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Case: Marine Envenomation Syndrome

A 62-year-old male presents to a regional emergency department in North Queensland after swimming within stinger nets. He develops back, abdominal and limb pain, vomiting, diaphoresis, severe hypertension and tachycardia.

1. What is the most likely syndrome or cause of this patient’s symptoms? 1 mark

Some literature supports IV clonidine, but the optimal dose is not established.

2. State 4 medications you would use to treat this patient’s symptoms. 4 marks

3. Name 3 potentially life-threatening sequelae from this syndrome. 3 marks

Despite initial treatment, 4 hours after arrival the patient continues to complain of pain and is becoming more breathless. He has moderate work of breathing, with a respiratory rate of 30 and oxygen saturations on 2L/min nasal prongs of 88%

4. List 5 potential reasons for this man’s dyspnoea. 5 marks

5. List 5 investigations that are now indicated given the patient’s ongoing symptoms of pain, cardiovascular instability and tachypnoea. Provide justification. 5 marks

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