60 year old male pt, smoker.
C/O chest pain, known case of:
DM ،HTN ،Old ICVA ،IHD
👉Presented to ER with severe respiratory distress, dyspnea grade IV with frothy sputum, peripheral and central cyanosis
BP: 220/120
👉Diagnosis:
-Acute pulmonary edema
-Emergency HTN (BP 220/120)
CO₂ narcosis (CO₂ = 89)
-Respiratory acidosis
Admitted to ICU as:
CPAP
-Lasix 80 mg – 80 mg – 40 mg
-Nitroglycerin 50/50, 5 ml (according BP
-Foley's catheter
-Pantoprazole 40 mg IV stat
Pt becomes ↓ LOC
Vital signs:
HR: 139
BP: 129/70
SpO₂: 90%
Admission advice (ICU) :
-Lasix 80 mg – 80 mg – 40 mg then 20 mg IV TDS
-Nitroglycerin 0.5 mg Stat
-Propofol 5 cc → 3 cc Stat
-Pantocid (Pantoc) 40 mg IV OD
-Aspirin 100 mg tab OD
-Ator 40 mg tab OD
-Foley's catheter
-Input / Output chart
-Ceftriaxone 1 g IV BD
-Dapagliflozin 10 mg tab OD
-RBS Q6h + Insulin
-Ramipril 2.5 mg tab OD
-CPAP then O₂ mask
-Nitromak 2.5 1*2
-heparin 25000 IU in 50 Ml Rate 2ml /h
-plavix 75 mg 1*1
-DO: ECG, CBC, RFT, S/E, Lipid profile, HbA1c, TSH, T4, Echo
