An ICU patient has become increasingly ‘puffed’ post-tracheostomy. Can you figure out why? What are your going to do about it?
Alarmingly high pressures…
July 29, 2010 By 3 Comments
A mechanically ventilated patient has high peak inspiratory pressures. You need to silence that incessant the alarm… What are you going to do?
Bronchospastic Blood Pressure Badness
July 26, 2010 By 3 Comments
A young man has been intubated for severe asthma. Now his blood pressure is heading for the floor. What are you going to do about it? Think you can save a life?
Man versus Machine
July 22, 2010 By 2 Comments
A patient develops hypoxia soon after intubation. Where lies the problem? Is it man or machine?
Puzzling out the PERC rule
May 27, 2010 By 4 Comments
Lung collapse, recruitment and bronchoscopy
April 14, 2010 By Leave a Comment
A 19 year old male is admitted after a severe traumatic brain injury. Due to refractory intracranial hypertension he is intubated and receiving 20mg an hour of morphine, 20mg an hour of midazolam and 200mg an hour of propofol.
Rapidly progressive respiratory failure
January 26, 2010 By Leave a Comment
A 30 year old male presents with a 3 day history of fevers and increasing breathlessness. On presentation he is noted to be severely hypoxic with sats of 80% on room air. The following chest X-ray is obtained:
A Case of CO2 Narcosis
January 12, 2010 By Leave a Comment
A 67 year old gentleman with a BMI of 45 was waiting for his respiratory outpatient clinic appointment. While waiting, he fell asleep. A medical emergency was called because he could not be woken up. On arrival of the MET team the patient is found to have a blood pressure of 140/70, a heart rate of 100bpm and oxygen sats of 68% on room air. He is breathing spontaneously but requires airway support. His GCS is 3/15. Supplemental oxygen is applied and the following arterial blood gas is obtained.
The Patient is Ballooning Up…
January 4, 2010 By 2 Comments
A 36 year-old immunosuppressed male was infected with swine-origin influenza virus requiring mechanical ventilation. Overnight the inspiratory pressures needed to maintain his tidal volume had progressively increased and his face had become markedly swollen.
HIV, pneumonia and bronchoscopy
December 22, 2009 By Leave a Comment
A 17 year old female with a background history of HIV presents with a 3 day history of fevers, chills and rigors. Her admission chest X-rays are shown below:
