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Pulmonary Pearls Edward Omron MD, MPH Pulmonary/Critical Care Medicine
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Physical Exam ,[object Object],[object Object],[object Object],[object Object],[object Object]
Initial Tests ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ER Chest X-RAY
What is the most likely pathogen in this patient? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Initial Treatment in the ER ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What antibiotic regimen would you prescribe in the ER? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Initial antibiotics given in the ER ,[object Object],[object Object],[object Object],[object Object]
Follow Up ,[object Object],[object Object],[object Object],[object Object]
Community Acquired MRSA Sensitivity in this patient ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CA-MRSA Pneumonia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CA-MRSA: 48 hours of destruction Admission 48 hours later
 
 
 
 
 
Healthcare Acquired Pneumonia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
59 yo with dyspnea and increased work of breathing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CXR
COPD Management  Non-invasive ventilation ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
COPD Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Severe COPD Normal
Severe COPD Normal
ABG INDICATION ,[object Object],[object Object],[object Object],[object Object]
Blood Gas  Report( Arterial ) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Changes in PO 2  and PCO 2  as oxygen moves from atmosphere to arterial blood
[object Object],[object Object],[object Object],[object Object],[object Object]
ANALYSIS OF OXYGENATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Alveolar-Arterial Oxygen Difference ,[object Object],[object Object],[object Object],[object Object]
Changes in PaO 2  and PAO 2  with age
Arterial Oxygen Values ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Changes in P(A-a)O 2  with FIO 2
Causes of  a low PaO 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Alveolar Hypoventilation ,[object Object],[object Object],[object Object],[object Object]
Pulse Oximetry ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pulse Oximetry Whole Blood PaO2 SaO2 SpO2: Pulse Oximetry ABG
Problem ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Methemoglobin ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Co-oximetry ,[object Object],[object Object]
Oximetry ,[object Object],[object Object],[object Object],[object Object],[object Object]
Oximetry ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 

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Pulmonary Pearls

Editor's Notes

  1. There are 3 reasones why one should obtain a blood gas:
  2. This is a typical printout from a blood gas report:
  3. Recall altitiude Recall RS Allows to assess properly if the lungs are transferring loxygen appropriately into the blood