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• Hx. Of NIV in UCH • Very distressing to him • Refuse any invasive procedure to prolong dying • Patient and family opt for DNR in Sept.2010 • “DNR” written in CMS ALERT 25
Page 1 and 2: Case presentation Dr. W.S. Ng Dr. K
Page 3 and 4: • On arrival, vital signs • BP
Page 5 and 6: Proceed to RSI for mechanical venti
Page 7 and 8: • Approach by ABC • P/E • Tac
Page 9: Investigations • ECG • At Arter
Page 13 and 14: Sliding sign Comet tail artifact 13
Page 15 and 16: Now patient got Type 2 respiratory
Page 17 and 18: • RSI • Suxamethonium 75mg •
Page 19 and 20: Progress • Extubate on the same d
Page 21: • PHx. • Retired businessman
Page 27 and 28: Pulmonary fibrosis • Scarring in
Page 29 and 30: Complications • Pulmonary hyperte
Page 31 and 32: Prognosis • Life expectancy 2-5 y
Page 33 and 34: Guideline 33
Page 35 and 36: • Resuscitation decision should b
Page 37: • DNR • Forego resuscitation me
Page 41 and 42: Advance Directives & Advance Care P
Page 43 and 44: • Operation of AD • Terminally
Page 45: Thank you 45

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