Deadly Respiratory Distress Mimic

Medic 534, staffed by a paramedic and EMT, is dispatched to a nursing home for a 78-year-old female in respiratory distress. On arrival, the crew finds the patient in a chair accompanied by two nurses and the administrator on call. The patient is in obvious distress showing fatigue and an increased work of breathing. She is alert to voice, but diaphoretic, lethargic, and unable to speak due to rapid, shallow breathing. A nurse is administering a nebulizer containing 3 mL of albuterol sulfate/ipratropium. A second nurse states that the patient has been in increasing distress for the last 45 minutes. The nurse also says that the patient has chronic obstructive pulmonary disease (COPD) and is experiencing an “exacerbation.” This is the second nebulizer treatment the staff has administered in the last 20 minutes. According to the administrator, the patient was discharged from the hospital 3-4 days ago after treatment for an infection. The patient has a history of COPD, non-insulin dependent diabetes, urinary tract infections, and had an ischemic stroke about two years ago. The patient’s medication list is consistent with her medical history and includes a recent prescription for prednisone. She’s allergic to sulfamethoxazole/trimethoprim and penicillin. On examination, the patient’s respirations are shallow and rapid at 32 breaths per minute. However, her lung sounds are clear bilaterally with good air entry into the bases. Her pulse rate is 125, her...
Source: JEMS Patient Care - Category: Emergency Medicine Authors: Tags: Airway & Respiratory Patient Care Source Type: news

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