MedBugs: SAQ #78

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Case: SOB with respiratory sepsis

A 78 year old woman with a past history of COAD, Type 2 diabetes, hypertension, hypothyroidism, presents with SOB in the setting of respiratory sepsis. On arrival, she looks unwell with increased work of breathing. Her initial examination findings are:

A — patent
B — RR 32, SaO2 94% on room air, creps at right base, expiratory wheeze bilaterally
C — HR 125 /min, BP 105/70. mmHg
D — GCS 15/15
E — Temp 39.3 oC, BSL 18 mmol/L

She has no epidemiological risk factors for COVID-19 but precautions are taken given she has respiratory symptoms. Early in her presentation she receives IV antibiotics, slow IV fluids, bronchodilators and corticosteroid. While in the department her oxygenation deteriorates and she looks more unwell.

1. List (3) different oxygen delivery devices which can be use for improving oxygenation in this patient with (1) benefit and (1) disadvantage for each. 6 marks

2. State (4) steps you would do in preparation for intubation 4 marks

3. List (4) potential causes and state key management steps for each 8 marks

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Case: SOB with respiratory sepsis

1. List (3) different oxygen delivery devices which can be use for improving oxygenation in this patient with (1) benefit and (1) disadvantage for each. 6 marks

2. State (4) steps you would do in preparation for intubation 4 marks

3. List (4) potential causes and state key management steps for each 8 marks

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