Acute Liver Failure
A 44-year-old female is brought in by ambulance with a reduced level of consciousness. She has known alcohol dependence.
Observations on arrival:
- Oxygen saturations 95% on room air
- Respiratory rate 18 breaths per minute
- Heart rate 110 beats per minute
- Blood pressure 116/65mmHg
- Temperature of 38.1oC
She is groaning and shouting out incoherently. There is evidence that she has been vomiting. She has generalised abdominal tenderness and is obviously jaundiced. On arrival, intravenous access is secured and blood samples including blood cultures are collected.