Classic case of Hypocalcemia 42 year old male presented to ER with painful carpal spasm since 30min after consuming alcohol sudden in onset. No ho fever / CP/SOB/ dehydration/ headache/ Kco DM not on medication. Smoker alcoholic Vitals BP 170/100mmHg Grbs 153mgdl Pr 90/min Rr 24/min Spo2 97% on room air Temp 98F Ecg LVH pattern Examination Red eyes prolly due to the influence of alcohol Aggressive demeanour None of the systemic findings came positive except for trousseau sign + Pitting Pedal edema I quickly sent abg and s calcium. S. cal was 7.8 K was 2.7 Na also on 127ish 10% Calcium gluconate slow Iv Slow Nacl 0.9% Took physician opinion. KCL he asked to start But then for high concentration electrolyte icu admission required. They had insurance that didn’t work in our hospital,they refused. Discharge them against medical advice . Explaining them risk of tr
Doctor . Emergency Physician .Flip side of medicine Drama. Rant Alert.