A 49years outdated white male present to the emergency room lamented of choking while ingesting dinner with the nursing residence he lives. He has a significant earlier medical history of traumatic brain injury, Breathing difficulties, Pneumonia, seizure disorder and Spasm quadriparesis. Patient denies shortness of breath, heart problems and fever, family history can be noncontributory. In Physical examination patient can be well nourished, no signs of distress, warn and conscious and the essential signs expose * Blood pressure 110/60
5. Pulse ninety six
* Vividness 90%
5. Heart appear вЂ“ usual
* No cyanosis
* Breath of air sound- decreased on the right lung and patient was afebrile. Recovered tracheostomy and there was increased spasticity on the left arm and left calf. The patient happens to be on the pursuing medications: 2. Atorvastin to get cholesterol
* Bedofen to get muscle spasm,
* dantrium for spasticity,
* Famotidine for GERD,
* Depakote for seizures.
Blood gas and X-ray was ordered and the ABG result expose " A PARTIALLY PAID RESPIRATORY ACIDOSIS WITH MODERATE HYPOXEMIA. PH 7. 23, PCO2 sixty five, HCO3 thirty four. 2, Pa02 50, Sp02 83. 5%. The 1st X-ray shows no lively disease. Yet , repeat xray 3 hours later showed complete opacification of the right lung and right top lobe atelectasis. posteroanterior chest radiograph is shown under Lab Function
His white blood cell rely is 12. 4 by 109/L(5. 0-10. 0x109) with 78%(normal is definitely 40-75%) segmented neutrophils, these types of elevated white-colored blood cell indicates a lot of infection going on and He is also mildly anemic seeing that his hemoglobin count is definitely 11. 0 g/dl when compared to normal 13. 5-16. 5 and his platelet count is at normal limitations (252 back button 109/L). DIAGNOSES
Dr . Sharif Ahmed clinically diagnosed an HOPE PNEUMONIA
Affected person was cured with a BPAP, antibiotics were started with Zosyn and Levaquin, nebulization (albuterol 2 . 5 mg) and steroid drugs (budesonide) was also believed. Another ABG was operate and this may be the result: PH 7. thirty-six, PCO2...