32-year-old with viral gastroenteritis and 8–10 episodes of vomiting, showing haemodynamic deterioration across the shift.
Bed 6 is Mr. Patel, 32-year-old admitted earlier today around 1100 with persistent nausea and vomiting, likely viral gastroenteritis. No significant past medical history. He reports about 8–10 episodes of vomiting in the last 24 hours and hasn't really kept food down. He's been tolerating small sips of water but says he still feels queasy. No diarrhea. Vitals through the afternoon have been trending slightly off. At 1200 his BP was 118/76, HR 92. By 1600 his BP was 106/68, HR 104. At 1800 he was 100/64, HR 110. He says he feels lightheaded when standing. He's on IV normal saline at 125 mL/hr since admission. Labs from 1300 showed sodium 147, potassium 3.2, creatinine 124 (no known baseline), BUN mildly elevated. Repeat labs haven't been drawn yet. Urine output has been lower than expected, around 25–30 mL/hr this afternoon. He voided about 150 mL at 1730. Urine looks concentrated. He's asking if he can start drinking more water because he feels very thirsty. He looks tired but is alert and oriented. No abdominal pain. Abdomen soft. Nothing urgent right now, just continue fluids and monitor.
Step 1 of 6: Situational Awareness