17th February 2025

A 66-year-old man is taken to A&E by ambulance after having progressively worsening shortness of breath and cough.

A 66-year-old man is taken to A&E by ambulance after having progressively worsening shortness of breath and cough. His CXR shows hyperinflated lungs with a flattened diaphragm. His wife reports he smokes 15-20 cigarettes a day. He is hypoxic on admission and put on 60% oxygen via a Venturi mask. He is prescribed salbutamol and ipratropium nebulisers and prednisolone.

Following this, observations are: HR 103, BP 130/65, RR 25, SaO2 90%, temperature 36.5., GCS 15.

An ABG performed on 60% oxygen shows pH 7.28, pCO2 11, pO2 7.5, bicarbonate 41, lactate 1.4. 

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