SAQ Stack

Short Answer Questions for ED Fellowship Study

Case: Respiratory sepsis with hypoxia

A 78-year-old woman with COAD, diabetes and hypothyroidism presents with shortness of breath and respiratory sepsis. On arrival she looks unwell with increased work of breathing. A - patent B - RR 32 SaO2 94% on room air, creps at right base, expiratory wheeze bilaterally C - HR 125 BP 105/70 D - GCS 15 E T 39.3 BSL 18 Early in her presentation she receives IV antibiotics, slow IV fluids, bronchodilators and corticosteroids. Her oxygenation then deteriorates and she looks more unwell.

1. List three methods of improving oxygenation in this patient with one pro and one con for each. 3 marks

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She continues to deteriorate with worsening hypoxia and hypotension. You feel that she requires intubation.

2. State five steps you would do in preparation for intubation. 5 marks

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Post intubation, her BP drops to 85/50.

3. List (2) potential causes and state a management step for each. 4 marks

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This case forms part of a collaborative marking project designed to support fellowship preparation. In the week leading up to each tutorial, you can contribute answers to any active case. If you contribute, your answers may be reviewed, marked, and used to refine the model answers during the weekly fellowship teaching sessions.

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After the tutorial you can still do the case and self-mark your answers, but your answers will not be included in the group review.