Thread subject: NEPI :: Interesting case

Posted by stemlyns on 10-01-2011 15:31

A 62 yr old Male patient brought with history of collpase.
On arrival

B-Good air entry bilaterally with no wheeze or crackles SaO2-88% on air
C-BP 85/40 Pulse 132/min
D- Alert GCS15/15 ,Abdomen- Soft non tender

Patient is c/o minimal upper back/thoracic pain.No h/o recent lower resp tract infection symptoms.Wife says he was not well and feeling depressed for the past 3-4 days and was always lying on the bed.

No significant Past medical history apart from hypertension and hypercholestermia

Sticking some 100% high flow O2 has improved his SaO2 to 91% but a litre of IV fluids has not made any difference in his BP

ABG- pH-7.38 pCO2-3.4, pO2-7.2, HCO3-25, BE(-1.5), Lactate-2.1

Next investigation or Differential?????