42M with sudden SOB and pedal edema.
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Patient brought to casuality with complaints of SOB at rest and pedal edema.
Bp at the time of admission 230/100mmhg
Pr 110 bpm
RR 34 cpm
Spo2 - 55% on RA.
Patient was given inj. NTG and Diuretics.
Post NTG BP 170/90.
ABG : metabolic acidosis
Post CPR ecg
Inspite of high flow oxygen patient spo2 is 65%. Patient is planned for intubation.
Pre intubation patient suddenly became unresponsive with no central pulses. Immediate CPR was done and Patient revived.
Post CPR & intubation
Patient was sedated and paralysed over night in ACMV-VC mode with peep 6-7 fio2 40%, Vt 450ml.
Day 1 :
S - patient is off sedation & paralysis and moving all 4 Limbs and responding to commands (1 step )
O - bp 140/90
Pr 82 cpm
RR 22 cpm
Spo2 97%
Cvs S1 S2 heard
RS - BAE PRESENT
E4VtM6
Trop i = 346 to #20230
A - acute cardiogenic pulmonary edema 2to ?NSTEMI with ? Aspiration pneumonia
P - plan to extubate if criteria meets.
Patient extubated successfully as he met extubation criteria.
Patient was observed for 2 days. As he is hemodynamically stable and angina resolved and was sent to cardiologist for opinion.
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