SAQ 1544 – Failed NIV in infective COPD exacerbation

Marked out of 11.00

Your registrar has placed a 67-year-old woman on bilevel non-invasive ventilation after assessing an infective exacerbation of chronic obstructive airways disease. She has failed to improve after 15 minutes of NIV.

Her vital signs are GCS 3, pulse 120/min, BP 95/55 mmHg, oxygen saturation 100%, respiratory rate 8/min, and temperature 38.5 C. You agree with the diagnosis and believe aggressive intervention is appropriate.

Test Result Reference range
FiO2 0.9
pH 6.88 7.35-7.45
PCO2 149 mmHg 35-45
PO2 335 mmHg 80-100
HCO3 44 mmol/L 18-26
Sodium 140 mmol/L 135-145
Potassium 3.5 mmol/L 3.2-4.5
Chloride 89 mmol/L 100-110

List two pathological processes related to her acid-base status. For each, provide an explanation.

(Marked out of 4.0)


/ 4

List the other important pathological process and include the formula used.

(Marked out of 2.0)


/ 2

List five further ED management steps.

(Marked out of 5.0)


/ 5

Total Score: 0 / 11

Percentage: 0%