SAQ Stack

Short Answer Questions for ED Fellowship Study

Case: SOB with respiratory sepsis

A 78 year old woman with a past history of COAD, Type 2 diabetes, hypertension, hypothyroidism, presents with SOB in the setting of respiratory sepsis. On arrival, she looks unwell with increased work of breathing. Her initial examination findings are:

  • A — patent
  • B — RR 32, SaO2 94% on room air, creps at right base, expiratory wheeze bilaterally
  • C — HR 125 /min, BP 105/70. mmHg
  • D — GCS 15/15
  • E — Temp 39.3 oC, BSL 18 mmol/L
She has no epidemiological risk factors for COVID-19 but precautions are taken given she has respiratory symptoms. Early in her presentation she receives IV antibiotics, slow IV fluids, bronchodilators and corticosteroid. While in the department her oxygenation deteriorates and she looks more unwell.

1. List (3) different oxygen delivery devices which can be use for improving oxygenation in this patient with (1) benefit and (1) disadvantage for each. 6 marks

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2. State (4) steps you would do in preparation for intubation 4 marks

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3. List (4) potential causes and state key management steps for each 8 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.