A 65-year-old female is scheduled for spinal surgery. She ha…

A 65-year-old female is scheduled for spinal surgery. She has a past medical history of CAD and HTN, atrial fibrillation. Her pre-op CXR is shown below. CXR4.jpg Which of the following is most helpful in predicting her risk of postoperative of respiratory failure?

A 45-year-old male with morbid obesity (BMI 55) presents to…

A 45-year-old male with morbid obesity (BMI 55) presents to the ED at 6 AM with right leg pain, and cellulitis that has kept him awake all night. He is admitted to the ward and his fevers and skin examination are improved with antibiotics during the first 16 hours of hospitalization. At 2 AM you are called to evaluate the patient for ICU admission because of somnolence and hypoxemia (SpO2 falling to high 70s on 2LNC). The rapid response team had difficulty waking the patient and ABG was performed before your arrival in the patient’s room: 7.29/74/52. Following arterial puncture, the patient woke up and by your arrival he is able to converse but remains sleepy with eyes closed, denying dyspnea, with SpO2 now 92% on 2LNC, and normal work of breathing. Medication history was reviewed, and no opiates have been administered. The ward team is requesting ICU transfer because of acute hypercarbic respiratory failure and initiation of BiPAP. You review recent laboratory test results and note that serum bicarbonate has been 38 to 40 over the last 6 months.Which of the following statements is true?

A patient being seen for adhesive capsulitis of the right sh…

A patient being seen for adhesive capsulitis of the right shoulder has completed her exercises and is placed on ice to assist with inflammation and pain. After approximately 5 minutes on ice the complains of pain in her hand. The PTA notes a significant color change in the hand described as red/purple with blanching in the fingers. What is the best course of action?

A 65-year-old male with a history of COPD and active tobacco…

A 65-year-old male with a history of COPD and active tobacco use with no prior intubations presented to the emergency department with increased work of breathing and increased wheezing. In the emergency department, he was given stacked nebulizers and IV steroids and initiated on BIPAP. His initial blood gas demonstrated pH 7.2/ pCO2 75/ pO2 65. Following intubation, he was placed on volume control ventilation. His initial peak pressure (peak inspiratory pressure ) was 45 cm H2O, and his plateau pressure (Pplat) was 35 cm H2O. He was placed on a respiratory rate of 30, PEEP 15, FiO2 0.40 and his SpO2 was 90%. Two hours after arrival to the ICU, his ventilator starts to alarm for high pressures. His peak pressures have increased to 65 cm H2O, and his plateau pressure has increased to 55 cm H2O. His heart rate increases from 80 beats per minutes to 110, and his blood pressure drops from 110/70 to 80/50 mm Hg. His SpO2 drops to 75%. His examination is notable for continual wheezing and slight deviation of the trachea toward the left.What is the most likely cause for this acute change?