Case 2
A 35-year-old lady with brittle asthma presents with an acute exacerbation. She has had one previous intensive care admission and is under the respiratory physicians, whom she sees regularly.
Her husband tells you she has been using more of her inhalers for 24 hours and although they initially seemed to help, they no longer are effective.
The patient is pale, sitting forwards, moving her shoulders when she breathes and looks exhausted. When you listen to her chest, there is a quiet wheeze, but not much air movement.
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Question 1 of 2
1. Question
Her initial observations show:
Initial observations ABG •Pulse 136 bpm regular
•BP 105/62
•Respiratory rate 30
•Saturations 91% on air•pH 7.32
•pO2 9.2
•pCO2 6.7
•bicarbonate 24
•lactate 2.3Describe the acid-base picture:
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Question 2 of 2
2. Question
Which 4 features in the history are especially worrying?
Patient presentation recapA 35-year-old lady with brittle asthma presents with an acute exacerbation. She has had one previous intensive care admission and is under the respiratory physicians, whom she sees regularly.
Her husband tells you she has been using more of her inhalers for 24 hours and although they initially seemed to help, they no longer are effective.
The patient is pale, sitting forwards, moving her shoulders when she breathes and looks exhausted. When you listen to her chest, there is a quiet wheeze, but not much air movement.
CorrectIncorrect