Discuss the implications for paramedic practice

You are tasked to a 53 yo male with increasing shortness of breath

Case

You are tasked to a 53 yo male with increasing shortness of breath

Assessment

Patient is pale cool, clammy, looking fatigued and unwell, Dizzy

RR 28, SpO2 95%, BP 180/110, HR 75, Cap refill >3 secs,

ECG

Eyes, Pale conjunctiva, pupils EARRL size 2 sluggish, peri-orbital oedema

Lungs – bibasilar crepitations,

Normal heart sounds

Abdo distended, extremities pitting oedema to the sacrum,

PMHx

Nil allergies

End stage renal disease on haemodialysis x 3/week, HT, Diabetes, Hyperlipidaemia, Coronary artery disease, asthma

Medications – lisonopril, glargine, novorapid (Sliding scale), aspirin, simvastatin, salbutamol, breo, hydrocortisone cream,

FHx – HT, diabetes, CAD

Social history – smoker, occasional EToH, no recreational drugs

What do you know about the patient? What is the key information? What do you still need to find out?

Outline 3 provisional diagnoses.

Discuss your final diagnosis and the pathophysiology behind the diagnosis.

Discuss the implications for paramedic practice.