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Old 09-29-2016
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Default What's the answer, and why?

6 hour after cabg a 62 year old M has decreased systolic BP from 120/80 to 100/85. Urinary output decrease from 60 to 10. CO decease fro 6 to 3. Pulmonary artery diastolic pressure has increased. CXR shows widened mediastinum..what's the most appropriate next step?


A.administration of 2 ampules of sodium bicarb
B,epinephrine
C.placememnt of intra-aortic balloon
D.revision of coronary gaft
E.surgical exploration of the mediastinum

I know the answer is E, but why is it E? If the BP has dropped and so has the CO, isn't it better to give epi first so patient doesn't go into shock?
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