Case 2 concluded: Hypoxemia

Sincere apologies for the delay in this post. To summarize Case 2, we have a 50 year old woman with ovarian cancer who is extremely hypoxemic despite supplemental oxygen and positive pressure ventilation is being considered. I’d like to  use this post to introduce a couple of other great #FOAMed resources.

The questions to think about were..

1) What is your approach to undifferentiated hypoxemia?
A recent post found here by Mark Yoffe on his website does a great job reviewing a general approach to hypoxemia.
In this lady with an oncologic diagnosis, pulmonary embolus is high on the differential. However, shunting due to pneumonia and/or ARDS should also be considered.

2) Who would be a candidate for non-invasive ventilation?
Stay tuned for a comprehensive review on this topic!

3) How would you approach intubation in a severely hypoxemic patient?
Scott Weingart of EMCrit‘s article in the Annals of Emergency Medicine, found here, is a fantastic review on preoxygenation and prevention of desaturation during intubation.

I’m interested in whether people would consider non-invasive ventilation in this patient. Would you? Discuss with #icurounds on twitter.

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