Scene The patient (72 kilograms) is sitting on a park benc…
Scene The patient (72 kilograms) is sitting on a park bench in the tripod position. She is alert but anxious. You hear audible wheezing as you approach the patient. She has a history of asthma, and her medications include albuterol and montelukast. The patient has no allergies to medications. The patient’s skin is warm and dry. Cyanosis is noted to the patient’s lips and mucous membranes. There are no signs of trauma, and the patient obeys motor commands. Her eyes open spontaneously and are 3 mm and reactive to light. The vital signs are BP 106/74, P 114, R 26, SPO2 88% on room air, and T 98°F (37°C). The blood glucose is 104 mg/dL. Which of the following initial signs or symptoms is consistent with early onset asthma?
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Post Scene After initial treatments, the patient continues to have increasing difficulty with breathing. He is becoming lethargic and does not follow commands. The vital signs are BP 134/86, P 128, R 38, SPO2 83% on room air, and T 98°F (37°C). The blood glucose is 89 mg/dL. The ECG and ETCO2 are shown below. What changes to the patient’s signs or symptoms would indicate that treatment is improving the patient’s condition, and what changes would indicate that despite treatment the patient’s condition is worsening? Select two changes that would indicate improving and select the two changes that would indicate worsening.
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