MR M is an 80yr old frail gentleman who lives with his elderly wife. He was a heavy smoker for many years and is a regular patient of the emergency department. He has a history of emphysema due to his previous history of smoking 50-60 cigarettes per day. Mr. M was brought in by ambulance to the Emergency Department in acute respiratory distress. On arrival Mr. M is unable to speak in sentences, is diaphoretic, hypertensive, febrile, tachycardic and tachypnoeic . The Ambulance Officer states that Mr. M has become increasingly unwell over the past 3-4 days.
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Mr. M is a frail and under weight looking gentleman who requires acute medical attention on arrival, due to the severity of his presentation. His respiratory rate alone is 40 resps/min and he is using all his accessory muscles to aid in his respiratory effort. Due to the acuteness of his condition Mr. M could further deteriorate, and the worst possible outcome for Mr. M would be that he could have a respiratory / cardiac arrest (……
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