MedBugs: SAQ #482

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Case: Epigastric pain and progressive dyspnoea

A 48-year-old man, well-known to your department with alcohol dependence and chronic pancreatitis, presents with acute epigastric pain. He has had some analgesia and bloods are pending. While waiting to be seen, he is noted to become progressively dyspneic and you are asked to review him urgently. Vitals are as follows : GCS 15, HR 110, BP 150/95, RR 36 with mod increased WOB, Sats 92% 4L/min O2

1. List (2) relevant findings. (2 marks) 2 marks

2. What is the most likely cause of these findings? (1 mark) 1 mark

3. Complete the table below listing (5) causes of cardiogenic and noncardiogenic pulmonary oedema (10 marks) (Table 5.3.1 + 5.3.2 Cameron) 10 marks

The patient continues to deteriorate and is intubated.

4. What ventilation strategy would you employ? (5 marks) (ARDSnet protocol) 5 marks

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Case: Epigastric pain and progressive dyspnoea

1. List (2) relevant findings. (2 marks) 2 marks

2. What is the most likely cause of these findings? (1 mark) 1 mark

3. Complete the table below listing (5) causes of cardiogenic and noncardiogenic pulmonary oedema (10 marks) (Table 5.3.1 + 5.3.2 Cameron) 10 marks

4. What ventilation strategy would you employ? (5 marks) (ARDSnet protocol) 5 marks

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