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nick pulmcrit Profile picture
nick pulmcrit
@pulmtoilet
Dad/Husband | Current Pulm/Crit Attending | Former PCCM Chief Fellow | Former IM Chief Resident | ABG miser | Vent physiology | POCUS
Feb 21, 2023 • 12 tweets • 12 min read
🚨🚨🚨🚨another edition of #fromthetrenches🚨🚨🚨🚨
Recent case of mine —> clinical details altered for anonymity
59 year old male presents to ED with SOB. Family states was at home at fell in bathroom. Hx of HTN/DM. Unsure of meds or compliance to therapy. Arrival BP 79/42 😱😱 Patient was given IVF bolus but this worsened SOB—>started on Bipap—>intubation. Post tube pulse ox 77% on 100% and 10 PEEP 😫

Post tube CXR—->very convincing pulm edema

MICU called to help with oxygenation . Some concern for cardiac event but too hypoxic for Lab