Round 33 (Respiratory Distress)

You are working at Clerkship General when you are called to the resuscitation bay for a 55yo M presenting in respiratory distress.











Initial Vitals











* Temp 99.9* HR 110* RR 22* BP 122/82* O2 82% on BiPAP 10/5 100%FiO2











Critical Actions











* Correctly interpret CXR #1 (multifocal PNA)* Correctly interpret CXR #2 (bilateral PNTX)* Treat with Oseltamivir* Troubleshoot vent alarm#1 (increase sedation)* Troubleshoot vent alarm#2 (place bilateral chest tubes)











Further Reading:











Acute Exacerbation of COPD – EMCrit











COPD – EM@3AM