Case Study of Congestive Heart Failure

In: Science

Submitted By dianej2647
Words 378
Pages 2
Ellen Diane Windham 11/8/15
Case Study: CHF

Helen Montgomery * An 83-year-old female presents to ambulance crew after an episode of sudden weakness. A GP is on scene and has assessed the patient, deciding on hospital admission by ambulance as a matter of urgency.
History
Patient became very weak and was put to bed by NOK. Her breathing became very laboured and the NOK called for the local GP out-of-hours service to attend. The doctor was on scene within 15 minutes, and upon assessing the patient requested an ambulance transfer to the ED.
Initial Clinical Findings * Airway – clear & patent * C Spine – not indicated (MOI/NOI: episode of weakness) * Breathing – tachypnoeic * Circulation – Pulse present, irregular, tachycardic; skin colour normal, cap refill normal * Disability – No LOC before ambulance arrival, patient responding to verbal stimuli
Clinical Impression * ? Exacerbation of CHF * ? CVA * ? Post-seizure
AMPLE History * A – Allergic to penicillin * M – Currently taking Warfarin, Furosemide * P – History of CVA x 1 year, CHF * L – Last oral intake 7pm the evening previous * E – Son stated patient became very weak before going to bed
Observations
* Pulse rate 110bpm * Pulse rhythm Irregular * ECG rate 116 * ECG rhythm A Fib * Resp rate 24 per minute, regular, shallow * Resp quality Bibasal consolidation & rales on auscultation * SpO2% 89% @ room air * Cap Refill <2secs * BP 178/112 * Pupils PEARRL, size 4 * GCS 11/15 (E4, V2, M5) * BGL 14.4.0mmol/l
Pre-hospital care & management
GTN 800mcg given SL & Furosemide 40mg administered IV as patient was dyspnoeic with…...

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