Hospice / comfort care | Figure 1

dreynoso

Internal Medicine

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Asystole with #Pacemaker (spike, orange arrow) induced agonal cardiac beats in hospice patient

very elderly female, palliative care, bowel obstruction and perforation on syringe driver. Noticed fingers and toes very purple and slightly cold. Pt is alert and orientated. Any ideas??

Decubitus Ulcer

Large, painful hematoma on one of my hospice patients. At first nursing home staff reported that it happened while repositioning her, quickly grew into this. Pt became febrile and non responsive/imminent, pt has since passed. Noted moaning and restlessness when touched requiring large doses of subcutaneous Morphine and Lorazepam.

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?