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Differential diagnosis • Pulmonary • Asthma, COAD, PE, pneumothorax, pleural effusion, pneumonia, interstitial lung disease… • Cardiac • ACS, CHF, Cardiac tamponade • Psychogenic • Hyperventilation, panic attack • Others • anemia, anaphylaxis, endocrine, acidosis… 6
• Approach by ABC • P/E • Tachypnoic • Can hardly speak • Air entry was present both sides but shallow • Bilateral crepitations at lung base • Trachea central • No stridor • No ankle edema 7
Page 1 and 2: Case presentation Dr. W.S. Ng Dr. K
Page 3 and 4: • On arrival, vital signs • BP
Page 5: Proceed to RSI for mechanical venti
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 26 and 27: Pulmonary Fibrosis 26
Page 28 and 29: Diagnosis • Progressive shortness
Page 30 and 31: Treatment • limited treatment opt
Page 32 and 33: Now you know the history and DNR Wi
Page 34 and 35: HAHO guideline on in-hospital resus
Page 36 and 37: DNR Ambulance Command Standing Orde
Page 40 and 41: • Ambulance Command Standing Orde
Page 42 and 43: • Advance Directives (AD) • Bac
Page 44 and 45: • Advanced Care Plan (ACP) • A

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