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Basic Life Support and ACLS. Esther Tsang Nov 2011. Case 1. 70 year old man admitted for sepsis for the past one week. Treated with antibiotics but remains very ill. Course of illness complicated by acute renal failure. Was fairly stable during the morning.
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Basic Life Support and ACLS Esther Tsang Nov 2011
Case 1 • 70 year old man admitted for sepsis for the past one week. • Treated with antibiotics but remains very ill. Course of illness complicated by acute renal failure. • Was fairly stable during the morning. • Informed by staff nurse that patient is unwell.
On examination, patient gasping and appears slightly cyanosed. • Name the parameters you want to check.
SpO2 is 64% on room air. • What do you do? • Describe how you would oxygenate the patient? • What are the oxygen flow rates for the various methods of giving oxygen to the patient?
What are the indications for intubation? • Describe the equipment you would need for intubation. • How do you select the ETT size?
The nurse then tells you that the blood pressure is unrecordable. • What is the systolic blood pressure if the following pulses are palpable? • Carotid • Femoral • Brachial
The carotid pulse is still palpable. • What would you do now?
If the carotid pulse is not palpable, what would you do? What are the possible differential diagnosis? • Fortunately, your nurse helpfully comes and puts the patient on a cardiac monitor. The following are the cardiac tracing.
You see the above rhythm with no palpable pulse. What do you do?
Name the rhythms displayed above. What is the difference? How do you recognize them? • What do you do for each of them?