Case Study (Dec. 2nd, 2022)

🚨👉You are dispatched to a female patient who is short of breath.

You arrive on scene to find her in her house and is in obvious respiratory distress. Her brother says she has COPD, and she tried to take her inhaler but it didn’t work.

Vitals are in the video

❓What treatment would you like to start with?

❓If your first line of treatment fails, what treatment would you like to do next?

❓Would you like to start CPAP on this patient?

Geoff and Jennah are breaking this case down live at 11 AM MST (10PST, 1EST) 💯

Geoff and Jennah are breaking this down on IG and FB later today at 11AM MST!

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[kendraedmonds]

Check lung sounds first do an assessement and quickly gather other hx - make sure it is more in the line of copd exacerbation and not pulmonary edema or something else going on.
high flow O2 first, Duoneb asap,
Consider 2nd neb if needed after that, and consider cpap if Neb isn't working.

[greymanswiftandbold]

After initial assessment
1.Salbutamol/Ipratropium nebulised with 6-8 litres oxygen, 6 mins on/off
2. IM hydrocortisone
3.Pre alert and convey to nearest emergency department
4.ECG and constant reassessment en route.

[jernejjeromel]

1. 02, Berodual & Ventolin
2. MgSO4
3. Aminofilin
4. C-PAP

[propyro]

Up the O2, get CPAP ready if it's still needed and consider dexamethasone ... if ALS 5.0 has gone live.

[tiffanyhartlage]

NRB 15l liters while I work on a DuoNeb. Put her on the duo neb at 6lpm while she remains on NC at 6lpm as well, if this is not helping start CPAP possible with another duoneb treatment

[anthonygonzales]

My first line of treatment is to up the oxygen flow, I am going to assume she is on that cannula at 5 litres, so I would crank it as high as it could go.

If that fails, then we'll try a nebulizer treatment if available; typically albuteral, which is a common broncholdilator

Then we'll go to CPAP after treatment 1 and 2 fails, but at that point might as well transport ASAP

[robertvalitsky]

In US as a medic student high flow O2, IV, solumedol 125 mg, lung sounds if wheezy duineb, Albuterol SVN, CPAP with IM epi 0 3 mg