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UW has a similar q, answer is bronchoscopy to remove mucus, so that I picked A with hope that this method will help release obstruction due to mucus.
But I review again, this patient has hypoxia so B is the first step. ___________________ The Key to Succeed is Patience.
Dr_kholioo Forum Junior
Topics: 9 Posts: 74
03/08/07 - 04:30 AM  
 
  #3
i think E ___________________ “We all have great inner power. The power is self-faith. There's really an attitude to winning. You have to see yourself winning before you win. And you have to be hungry. You have to want to conquer.” Arnold Schwarzenegger
92306 Forum Senior
Topics: 14 Posts: 126
03/08/07 - 09:10 AM  
 
  #4
this pt has Resp acidosis with resp 10/min next step will be Reintubation and mechanical ventilation.
NE Forum Guru
Topics: 53 Posts: 504
03/08/07 - 12:05 PM  
 
  #5
E Criteria for intubation: -Uncorrectable hypoxemia (pO2 < 55 on 100% O2 NRB). - Hypercapnia (pCO2 > 55) with acidosis (pH<7.25) -Ineffective respiration (max inspiratory force < 25 cm H2O) -Fatigue (tachypnea with increasing pCO2). - Airway protection. - Upper airway obstruction. - Septic shock.
dr.shailu Forum Senior
Topics: 26 Posts: 191
03/08/07 - 12:19 PM  
 
  #6
ya ,it is E bcos giving oxygen alone doesnot correct his respiratory acidosis
Common medical indications for mechanicalventilation include (from wikipedia)
acute lung injury (including ARDS, trauma)
apnea with respiratory arrest, including cases from intoxication
chronic obstructive pulmonary disease (COPD)
acute respiratory acidosis with partial pressure of carbon dioxide (pCO2) > 50 mmHg and pH < 7.25, which may be due to paralysis of the diaphragm due to Guillain-Barré syndrome, Myasthenia Gravis, spinal cord injury, or the effect of anaesthetic and muscle relaxant drugs
tachypnea with respiratory rate > 30
hypoxemia with arterial partial pressure of oxygen (PaO2) with supplemental fraction of inspired oxygen (FiO2) < 55 mm Hg
hypotension including sepsis, shock, congestive heart failure
dr in trouble Forum Guru
Topics: 62 Posts: 610
03/08/07 - 01:34 PM  
 
  #7
yes its E . ___________________ If u want to do something, do it today as there is no tomorrow.