Feeling Blue: When a good night turns bad

Author: Susan U Bhroin / Editor: Sarah Edwards / Codes: / Published: 06/07/2021

Just after midnight an ambulance arrives with a 26-year-old female patient. A takeaway owner had called the emergency services after she became unresponsive in his restaurant.

Her vitals are as follows:

BP 90/40
Heart rate 140
Temperature 36.5C
Respiratory Rate 22
SpO2 85% on 100% O2 via non-rebreather mask
GCS 10 (E4, V2, M4)

From the end of the bed you notice she is profoundly cyanosed despite receiving 100% O2.

Your FY2 successfully obtains an ABG and she reads the following results to you as you secure IV access:

pH 7.28
PO2 42kPa
pCO2 3.5kPa
HCO3 13
Lactate 9.7

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