A 57-year-old male is brought to the emergency department by ambulance. He has a history of COPD and asthma, has smoked for 40 years, and continues to smoke. Ambulance officers found him severely short of breath and treated him with high-flow oxygen and continuous nebulised salbutamol en route.
The latest ambulance observations and ABG are shown below.
| Observation |
Result |
| BP |
160/80 mmHg |
| HR |
140 bpm |
| RR |
40 /min |
| O2 saturation |
86% on high-flow oxygen |
| GCS |
15 |
| pH |
7.12 (7.35-7.45) |
| pCO2 |
91 mmHg (35-45) |
| HCO3 |
30 mmol/L (22-26) |
| pO2 |
271 mmHg |
| Base excess |
-1 (-1 to 1) |
State six (6) factors you would consider when deciding whether this man requires intubation.
(Marked out of 6.0)
/ 6
Interpret this ABG in the clinical setting. Include four (4) points.
(Marked out of 4.0)
/ 4
Would you intubate him on the basis of these gases?
(Marked out of 1.0)
/ 1
State three (3) justifications for your decision.
(Marked out of 3.0)
/ 3
If he progresses to intubation, state four (4) points describing the ventilation pattern you would initiate.
(Marked out of 4.0)
/ 4
Total Score: 0 / 18
Percentage: 0%
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