Well, it’s been a while since I did a case study because I never think to remember things like these, but let’s do another. 

A 36 year old male with a history of alcohol abuse is found lying in a pool of vomit at home by his mother. He was apparently drinking heavily for the last 24 hours and was now unresponsive to painful stimuli. He had a grand mal seizure (45s long) followed by two shorter ones. His pupils were fixed and unreactive, so he was given IV Narcan (opiate antidote, did nothing), dextrose (volume expander), vitamin B12. He also showed signs of brain swelling so he was given IV mannitol.

If you were the physician, what would you order STAT for this patient? Remember that the only tests that should ever be requested stat and not routine are ones that will affect the course of treatment for the patient right then and there, so it is important to be judicious. That means no “drug screen” for you. 

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