Sunday, June 23, 2013

Medical

Medical

Question:
Hospital retrieval  Case A 49 year old man with chronic renal failure requires transfer to a tertiary hospital for renal dialysis. He has missed his last 2 treatments. He has a past medical history of anaemia, chronic obstructive pulmonary disease, previous myocardial infarction, and heavy ETOH (alcohol) consumption.  Clinical information  • Pulse: 100  • BP 105/60 mmhg  • Resps: 20  • GCS 15  • SaO2 92%  Blood analysis  • pH 7.31  • Potassium 5.9 mmol/L  • Urea 35 mmol/L  • Creatinine 1340 umol/L  • Hb 9g/dL  Relevant information;  Aircraft: fixed wing  Local resources: Local practitioner and one land ambulance  Retrieval options: tertiary centre 2 hours away by air  Time now: 2200 hours  Submissions questions
1. Is the patient safe to transport given this information? Give your rationale.
2. Midway through the flight the following occurs  a. The patient vomits 700mL of fresh blood into the O2 mask  i. Clinical information: Pulse 130, BP 85/45 mmHg, RR 26, GCS 9  b. Discuss the management of this in flight emergency. ……..
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