Case study Part 3a
This scenario presents a 67-years-old male with suspected COVID-19 admitted from the Emergency Department. The patient was admitted to 1 hour ago.
The patient’s respiratory rate appears to be increasing despite the oxygen therapy. On arrival his oxygen saturation was 89% on Room Air. Since he started on oxygen via nasal cannula his oxygen saturation is only 91% on 8 litres oxygen per minute. The patient has deteriorated and now has increased shortness of breath.
Diagnostic tests: Chest X-ray
Arterial Blood Gas Analysis
- Before oxygen administration: pH 7.31, PaCO2: 55 mmHg, PaO2: 45 mmHg, HCO3-: 27 mEq/
- On nasal cannula: pH 7.31, PaCO2: 55 mmHg, PaO2: 45 mmHg, HCO3-: 27 mEq/L (no change)
- If trying non-invasive ventilation: pH 7.26, PaCO2: 67 mmHg, PaO2: 40 mmHg, HCO3-: 27 mEq/L
- Post-intubation and on ventilator: pH 7.33, PaCO2: 46 mmHg, PaO2: 67 mmHg, HCO3-: 27 mEq/L
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Considering the patient’s condition, what is the next line of treatment for this patient?Grading can be reviewed and adjusted.Grading can be reviewed and adjusted.
Steps of intubationCorrectIncorrect