Saturday, April 21, 2012

Case Study 1: Respiratory Emergencies


35 yr old lady is admitted to the ED with complaints of SOB and cough for last 3 days. She is being treated with oral antibiotics for pneumonia by her GP. She suddenly develops respiratory distress and desaturates. The ED resident decides to intubate and mechanically ventilate the patient. Post intubation, air entry is found to be equal, and her saturations now are 95+ on FiO2 of 80. An XRC done as a protocol for post intubation is shown in the figure. What action must be taken at this moment?


a) Inform Respiratory Physician & Admit in ICU
b) Inform Respiratory Physician & Admit in Ward
c) Give injectable antibiotics
d) Reposition the tube
e) Increase FiO2 to 90 or 100 %, reduce TV, Give PEEP
f) Reduce TV, Give PEEP


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