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Pediatric HAL® Five Year - Cardiac Scenario
Cardiac Ischemia
Carbon Monoxide Poisoning
During the ride home from a family camping trip a five year old boy falls asleep in the back of his
parents truck camper. The night was cold so the heater in the cab was turned on. When they
returned home he seemed confused, couldn't walk and complained of a headache and vomited. His
parents bring him to the ED and are worried about meningitis .
Appearance:
Lethargic but responsive,
gait unstable
ST Segment Elevation
HR 150
RR 30
BP 120/70
Temp 37.5 Deg C
O2 Sat: 99%
Assessment: Suspect Carbon
Monoxide poisoning with cardiac
ischemia. Check for exhaled
carbon monoxide concentration
with micro COHb meter. COHb
is elevated at 25%. Send blood
for cardiac troponin
Assume vitals are related to a
“flu-like” illness. Perform a
physical exam and send CBC
and Strept test to the laboratory.
Send the boy for a chest X-Ray.
Thirty minutes later the has a
seizure and is now comatose
from cerebral edema.
No
HR 60
BP 140/90
Cheyne-Stokes
Seizures
Eyes closed
Pupils unresponsive
Transition Time: 45 sec
100% O2 delivered via
non rebreather mask
COHb has decreased to 20%.
Cardiac troponin is elevated.
Support the ABCs and arrange
for transport to a hyperbaric
chamber. The hyperbaric
chamber can displace the
carbon monoxide faster than the
oxygen given at atmospheric
pressure and better protect the
brain and heart from further
hypoxic damage.
Yes
Wait “15 minutes”
Healthy Vitals
Transition Time: 1 min
End
End
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