Question

A 22-year-old man sustains a gunshot wound to the abdomen and presents with shock. He requires multiple units of packed red blood cells during resuscitation. Later he complains of numbness around his mouth. Physical exam reveals carpopedal spasm and a positive Chvostek sign. An electrocardiogram demonstrates a prolonged QT interval. Which of the following is the most appropriate treatment?

1) IV bicarbonate
2) IV furosemide
3) IV calcium
4) IV insulin

Answer 1

The most appropriate treatment for a patient with signs and symptoms of hypocalcemia in the setting of shock is IV calcium.

Step-by-step explanation:

The patient in this scenario is presenting with signs and symptoms of hypocalcemia, which can occur in the setting of shock. Hypocalcemia can lead to neuromuscular irritability and manifest as numbness, carpopedal spasm, and a positive Chvostek sign. The prolonged QT interval on ECG is also consistent with hypocalcemia.

The most appropriate treatment for this patient is IV calcium. Calcium supplementation will correct the hypocalcemia and alleviate the neurological symptoms.