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

Related Links:

CONCLUSION: Our three cases suggest that tocilizumab may be an effective and safe treatment for ocular manifestation associated with relapsing polychondritis. PMID: 32643976 [PubMed - as supplied by publisher]
Source: Ocular Immunology and Inflammation - Category: Allergy & Immunology Tags: Ocul Immunol Inflamm Source Type: research
CONCLUSION: Patients with thyroid disease were found to have a higher risk for uveitis. For certain age groups or patients without diabetes or hypertension, the role of thyroid disease might be more crucial for uveitis development. PMID: 32643974 [PubMed - as supplied by publisher]
Source: Ocular Immunology and Inflammation - Category: Allergy & Immunology Tags: Ocul Immunol Inflamm Source Type: research
This study aimed to investigate the prognostic value of PNR and PWR in acute ischemic stroke patients treated with EVT. METHODS: Poor functional outcome was defined as Modified Rankin Scale (mRS) of 3-6 at 3 months, Symptomatic intracranial hemorrhage (sICH) was diagnosed based on CT scan and classified according to the criterial of Heidelberg Bleeding Classification. Binary logistical regression was used to analyze the relationship of PWR, PNR with functional outcome and symptomatic intracranial hemorrhage (sICH). RESULTS: Patients with good prognosis had higher PNR and PWR value (29 vs. 24, P=0.002) (22 vs. 19, P...
Source: Neurological Research - Category: Neurology Tags: Neurol Res Source Type: research
Authors: Okosun IS, Nkemjika S, Okosun B, Lyn R, Airhihenbuwa CO Abstract AIM: To determine differences in lifestyle modification practices and use of prescription drugs in a representative sample of Mexican American (MA), non-Hispanic White (NHW), and non-Hispanic Black (NHB) elderly Americans with metabolic syndrome (MetS). METHODS: Data from the United States National Health and Nutritional Examination Surveys were used in this study. Lifestyle modification practices include ongoing physical activity, weight control, and ongoing diet modifications. Prescription drugs include anti-diabetic, anti-obesity, lipi...
Source: Journal of the National Medical Association - Category: General Medicine Tags: J Natl Med Assoc Source Type: research
Publication date: Available online 27 June 2020Source: Journal of NeuroradiologyAuthor(s): Jérôme Berge, Gaultier Marnat, Régis Hubrecht, Louis Veunac, François Rouanet
Source: Journal of Neuroradiology - Category: Radiology Source Type: research
Publication date: 11–17 July 2020Source: The Lancet, Volume 396, Issue 10244Author(s): Bruce C V Campbell, Pooja Khatri
Source: The Lancet - Category: General Medicine Source Type: research
Publication date: 11–17 July 2020Source: The Lancet, Volume 396, Issue 10244Author(s): Deepak L Bhatt, Philippe Gabriel Steg
Source: The Lancet - Category: General Medicine Source Type: research
Publication date: 11–17 July 2020Source: The Lancet, Volume 396, Issue 10244Author(s): Gerald Chi, Jolanta Marszalek
Source: The Lancet - Category: General Medicine Source Type: research
The coronavirus disease (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread exponentially worldwide. In Brazil, the number of infected people diagnosed has been increasing and, as in other countries, it has been associated with a high risk of contamination in healthcare teams. For healthcare professionals, the full use of personal protective equipment (PPE) is mandatory, such as wearing surgical or filtering facepiece class 2 (FFP2) masks, waterproof aprons, gloves, and goggles, in addition to training in care processes. A reduction in the number of face-to-face visits an...
Source: Clinics - Category: General Medicine Source Type: research
Publication date: Available online 10 July 2020Source: American Journal of Infection ControlAuthor(s): Luke Carmichael Valmadrid, Rebecca J. Schwei, Elizabeth Maginot, Michael S. Pulia
Source: American Journal of Infection Control - Category: Infectious Diseases Source Type: research
More News: Albuterol | Allergy & Immunology | Bactrim | Chronic Obstructive Pulmonary | Diabetes | Emergency Medicine | Endocrinology | Hospitals | Insulin | Ischemic Stroke | Nurses | Nursing | Penicillin | Prednisone | Proair HFA | Respiratory Medicine | Stroke | Sulfamethoxazole | Trimethoprim | Urinary Tract Infections | Ventolin