OXYGEN

Scenario 3

You are called to the emergency room (ER). A 62 year old male with a history of chronic bronchitis has been admitted with a lower respiratory tract infection. The ER resident is requesting admission to intensive care for mechanical ventilation. On examination, the patient is tachypneic and cyanosed. His blood gas is pH 7.34, PCO₂ 54, PO₂ 45, HCO₃ 30, BE-2.

You request a piece of information, perform a therapeutic maneuver and 30 minutes later the patient’s blood gas is: pH 7.32 pCO₂ 60 PO₂ 55 HCO₃ 31 BE 0. The nurse wishes to reduce the FiO₂.

What information did you look for? What therapeutic maneuver did you perform, and what do you plan to do about the last blood gas?

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