Location ED Introduction It is 0705hrs and you are working a…
Location ED Introduction It is 0705hrs and you are working a morning shift in the Emergency Department. During handover you hear the Batphone (emergency phone) ring indicating an emergency case is enroute via ambulance…. Situation 84 year old female – Tachypnoeic , hypoxic, hypotensive, tachycardic Increased work of breath/respiratory rate noticed by staff at the Residential Aged Care Facility who called 000 No IV access currently insitu Estimated Time of Arrival (ETA) to ED = 4 minutes. Background- discharged from hospital 5/7 ago post ORIF to R) hip after a mechanical fall PMH: AF, HT, dementia, osteoporosis, dyslipidaemia Drugs: Metoprolol 25mg BD, aspirin 100mg PO Daily, Atorvastatin 40mg nocte. Allergies: unknown Assessment/Observations from ambulance staff/on arrival to ED : A -maintaining own B – spontaneous, RR 36, Sp02 88% RA, increased work of breathing , accessory muscle use C – central capillary refill 4 seconds, HR 140bpm (rapid Atrial Fibrillation), BP 82/56 D – GCS 13/15 (E3V4M6), PEARL 3mm Brisk E – temp 38.9, diaphoretic +++, dressing insitu to R) hip wound with some strikethrough/purulent ooze evident. F – dry oral mucosa, dry pad insitu, fluid intake/output unknown G – Glucose 4.2.mmol/L A full blood count is taken on arrival WCC: 16.8 Hb:85 Hct:24.8 Na: 144 K: 3.3 Platelets: 187 INR: 2.2
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