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A 45-year-old male with a history of chronic obstructive pulmonary disease (COPD), asthma, amphetamine and tetrahydrocannabinol (THC) use, and coronary vasospasm presented to triage with chest pain. Cardiac arrest secondary to myocardial ischemia from coronary vasospasm is well documented. N Engl J Med. 1992;326(22):1451-1455.
He had COPD and depended on home oxygen. ” I documented those words in my progress note that day. KS died during the final one when his inpatient team failed to resuscitate him after a cardiac arrest. He had declined hospice care until the end and would not even accept “do not resuscitate” status.
This patient was reported to have distant heart sounds but was not hypotensive and did not have JVD according to documentation. Beck’s triad only happens all 3 together in approximately 1/3rd of patients. Smith comment : First, IV fluids are indicated to improve preload.
And sepsis-3 redefined septic shock as “hypotension not responsive to fluid resuscitation” with the added requirement of vasopressors to maintain a MAP greater than or equal to 65 and with a lactate > 2. Sepsis is coming in at a higher readmission rate and cost per admission than acute MI, CHF, COPD, and PNA. vasopressin.
Louis); Marina Boushra, MD (EM-CCM, Cleveland Clinic Foundation); Brit Long, MD (@long_brit) Case Emergency Medical Services brings in a 62-year-old male with COPD in acute on chronic hypoxemic respiratory failure (usually on 3 L nasal cannula, now on non-rebreather at 15 L/min).
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