The patient with acute lung injury (ALI)
Definitions of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) Adult respiratory distress syndrome was first described by Ashbaugh et al. in 1967 as a clinical syndrome different from…
The patient with increased abdominal pressure
On auscultation breath sounds are significantly reduced bi-basally. Arterial blood gas Hypoxaemia and a mixed respiratory and metabolic acidaemia on 60% facemask oxygen Cardiovascular Blood pressure 100/60 mmHg Heart rate…
The patient with an acute kidney injury
Pulse 105 bpm Sinus rhythm Temperature 38.5°C Respiratory Self-ventilating on 0.35 FiO2 (35%) via a face mask Respiratory rate 18 bpm SpO2 97% Arterial blood gas pH 7.32 PaO2 11…
The patient with severe upper gastrointestinal bleeding due to oesophageal varices
In view of his profuse bleeding, tachypnoea and decreased oxygen saturations, Mr Smith is electively intubated with a size 8.0 endotracheal tube prior to the insertion of a balloon tamponade…
The patient requiring sedation
PaCO2 5.7 kPa PaO2 7.6 kPa HCO3− 21 mmol/L Base excess −3.1 Cardiovascular Blood pressure 161/89 mmHg Temperature 38.1°C Heart rate 89 bpm (sinus rhythm) An infusion of propofol 100…
The patient following cardiac surgery
Reader activities Having read this scenario, consider the following: What are the key anatomical and physiological concepts for the cardiovascular system? In relation to cardiac anatomy, physiology and disease, what…
The patient with altered blood glucose
Pulse 102 bpm Respiratory Self ventilating on 50% O2 via a humidified face mask Respiratory rate 24 bpm Arterial blood gas pH 7.31 PaO2 9.5 kPa PCO2 7.0 kPa HCO3…
The patient with raised intracranial pressure
FiO2 0.5 via a non re-breathe reservoir bag/mask Arterial blood gas (ABG) analysis: pH 7.3 PaO2 11 kPa PaCO2 6.9 kPa Base Excess −4 Circulation Blood pressure 145/75 mmHg Heart…
The patient following poisoning
Patient scenario Femi is a 21-year-old female admitted to the emergency department in a collapsed state following recreational ingestion of 2 ‘ecstasy’ tablets over a 5-hour period. History from the…
The patient requiring end-of-life care
Denial Denial is usually only temporary. It is generally replaced with heightened awareness of situations and individuals that will be left behind after death Anger The individual recognises that denial…
