54 yo M took 50 75mg amitryptyline tablets and 100 25mg diphenhydramine tablets, came in drowsy incoherent later intubated. bp ok at 138/84 HR 108. QRS 138ms, bicarb initiated (unclear if bolused initially) and put on drip. Given intralipid 20% 100mL bolus then 1200ml over 1 hr (0.25ml/kg/min). BP remained stable overnight, QRS complex narrowed to 100 then 80 (likely pts baseline) and extubated next day.
Early use of intralipid for very large overdose of 2 QRS widening agents. Unclear what role bicarb played in narrowing QRS vs intralipid intervention.
Early use of intralipid for very large overdose of 2 QRS widening agents. Unclear what role bicarb played in narrowing QRS vs intralipid intervention.