Central Australia. She has been referred and admitted to hospital for
exacerbation of her COPD. She is currently receiving increased regular
salbutamol, oral steroids in addition to her regular medications and
intensive respiratory physiotherapy rehabilitation before returning to her
community in the next week.
Hx COPD, cor pulmonale
It is 0800 and you attend to undertake her observations. She looks at
you vaguely and asks where she is. However, after a moment she
seems fine. She seems a bit agitated and says she doesn’t want
breakfast because she feels like she needs to vomit.
Palliative Factors: Nothing makes me feel better
Q: aching
R: Everywhere
S: “not too severe, I just don’t
feel right”.
T: “I woke up during the night
feeling hot all over”.
• HR: 112bpm
• RR: 26 bpm
• Temp: 38.1°C
• Sp02: 87% on RA
Assessment
findings
Pulse – Regular, rapid and
palpable
JVP - not visible
Peripheries are warm
Pale
CXR - Nil evidence of enlarged
cardiac shadow or lung changes pre-
operatively.
ECG – Sinus Tachycardia
Assessment
• Dyspnoeic
• Increased Work of
breathing
• Generalised Bilateral
crackles
• Decreased lung sounds L
side
• Chest Xray – Extensive L
sided chest consolidation all
fields.
• LOC: A&O x3
• PERRLA
• Motor and sensory function
intact
GCS: 15- but slow to respond
After taking Ngarla’s vital signs at 0800 in the morning, her RR is 26 bpm, HR is 112 bpm and body temperature is 38.1 degree Celsius. This vital sign evident that she can be diagnosed with Systemic inflammatory Response Syndrome (SIRS). An individual is more likely to have SIRS if they meet two of the following criteria: body temperature is <36 or >38 degree Celsius, RR > 20 bpm or partial pressure of CO2 < 32 mmHg, HR > 90 bpm, and leucocyte counts > 12000 or < 4000 per microliters. Additionally, the presence of those criteria of SIRS along with the suspected infection can be identified as sepsis and Ngarla has a high risk of having chest infection as she is a COPD patient so she can be diagnosed with sepsis. Sepsis is a life-threating medical emergency and body’s toxic and hyperactive response to an infection causing dysfunction of organ, tissue damage or even death if it is not managed on time.
what might happen if the sepsis remains untreated without clinical intervention?
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