ABCDE Assessment | Sepsis | Emergency Simulation Scenario | OSCE Guide | UKMLA | CPSA

Summary

This medical interaction involves a 76-year-old patient, Rizal Linden, who is experiencing increased confusion after a fall. Junior doctor Leah conducts a comprehensive assessment, revealing signs of respiratory failure and possible sepsis from pneumonia. The patient is hypoxic, with low blood pressure and elevated heart rate. Interventions include oxygen therapy, IV fluids, and blood tests, alongside consultations with a senior doctor for urgent review. The protocol follows a structured approach to manage the patient's deteriorating condition, emphasizing timely medical care and assessment.

Takeaways

• 😀 Leah, the junior doctor, assesses a 76-year-old patient named Rizal who is experiencing confusion and respiratory distress.
• 😀 The initial assessment includes checking Rizal's identity, vital signs, and his overall condition as reported by the nurse, Katie.
• 😀 Rizal's vital signs indicate a high respiratory rate (29) and low oxygen saturation, prompting immediate oxygen therapy.
• 😀 Leah initiates an assessment of Rizal's circulation, discovering low blood pressure (89/63) and a high heart rate (140 bpm).
• 😀 The arterial blood gas results reveal type 1 respiratory failure and acidosis, indicating a serious underlying condition.
• 😀 Leah suspects pneumonia based on chest examination and chest X-ray results showing haziness in the right lung base.
• 😀 A comprehensive sepsis protocol, known as the Sepsis Six, is initiated, including administering oxygen, fluids, and blood cultures.
• 😀 During the neurological assessment, Rizal displays confusion but lacks focal neurological deficits, indicating no immediate brain injury.
• 😀 Leah effectively communicates her findings and concerns regarding Rizal's deteriorating condition to Dr. Potter, a senior clinician.
• 😀 The interaction showcases the importance of teamwork and clear communication in a medical setting, particularly in acute care.

Q & A

What is the patient's name and age?

The patient's name is Rizal Linden, and he is 76 years old.

What reason did the nurse give for Rizal's current condition?

The nurse mentioned that Rizal seems to be more confused this morning after a fall.

What assessments did Dr. Leah perform on Rizal?

Dr. Leah performed a top-to-toe assessment, including checks on his airway, breathing, circulation, and neurological status.

What were the findings of Rizal's respiratory assessment?

The respiratory assessment revealed a respiratory rate of 29, low oxygen saturation levels, and crackles in the lungs, indicating possible respiratory distress.

What treatment was initiated for Rizal's respiratory issues?

Rizal was placed on 15 liters of oxygen via a rebreather mask to address his low oxygen saturation.

What did the arterial blood gas results indicate?

The arterial blood gas results indicated type 1 respiratory failure and acidosis.

What was noted about Rizal's blood pressure and heart rate?

Rizal's blood pressure was recorded at 89 over 63, and his heart rate was 140 beats per minute, indicating hypotension and tachycardia.

What medication adjustments did Dr. Leah make based on her assessment?

Dr. Leah suspended Rizal's amlodipine due to his low blood pressure and prescribed fluids for resuscitation.

What did Dr. Leah suspect as the cause of Rizal's symptoms?

Dr. Leah suspected that Rizal may have sepsis, potentially from a chest source, given his symptoms and assessment findings.

What protocol did Dr. Leah plan to initiate for managing sepsis?

Dr. Leah planned to initiate the Sepsis Six protocol, which includes administering oxygen, fluids, and broad-spectrum antibiotics.