Please think about this case and answer the following questions for yourselves. We will cover them in the teaching.

A 52 yo presents with 2 days of increasing SOB and chest pain.

At rriage the sats are 62% on room air and the BP is 85/40

The patient is sent straight to a resus cubicle.

Monitoring and a non-rebreather mask is applied. An IV is inserted and pathology taken. Non-nvasive ventilation is prepared.

The patients blood gas  and ECG are shown below. Please think about these and interpret them. If you are having trouble with them I have included some references on this website that you can look at to help you. Scroll down for the rest of the case.

The patient’s ECG is shown below. Please think about this ECG and interpret.

Case Continued:

You cannot get any assistance in the Emergency Department and are the senior doctor on, ie., there is no MET call:

• What do you do next?
• What are your priorities?

This patient then becomes unresponsive. What do you do now?

Think about how you would approach this resuscitation.

Here are some references to help you with the Gas and the ECG.

Can the ECG help us differentiate PE from ACS?

The ECG in 20 seconds approach: Watch the Video

Interpreting the blood gas

Below is an infographic I have put together for you, so you can use for future gas interpretation. I will be asking you all to interpret gases in the emergency department. Please use this. Remember you won’t learn this all at once, but this will for a basis for what we keep doing. Keep it on your phone.

OKAY A big few days for you and a bit of learning.