#Case_1 64_year_old man with respiratory arrest . You are on the word when you hear ashout and run over to see what has happened . A man has collapsed and is lying on the floor his eyes are shut and his lips look blue . 1- What action should you take? 2-You find that he is not breathing but he has a weak pulse with a rate of 120 beats/min. How do you interpret this information? 3-What should you do now? 4-The patient’s airway is clear and he is given mouth-to-mask ventilation until the resuscitation trolley arrives. As he is still not breathing spontaneously, a Guedal airway is inserted and he is ventilated using a bag, value and face mask and high fl ow oxygen. His oxygen saturations are 93% and on listening to his chest he has air entry bilaterally with no added sounds. A cardiac monitor is attached and shows a sinus tachycardia at 112 beats/min. His blood pressure is 100/60 mmHg. You are able to review his wristband and notes. His name is David Robson, he is 64 and was admitted for investigation of a transient ischaemic attack. He has hypertension, but no other significant past medical history. What does this new information tell you about the cause of his respiratory arrest? 5-What are your options for managing his airway? 6-The anaesthetist arrives and takes over the care of Mr Robson’s airway and ventilation. She inserts an endotracheal tube and ventilates him via this tube using a bag, valve and face mask (Fig. 24) with entrained oxygen. After 10 min she stops ventilating him for a short period to see if he breathes spontaneously. Why did the anaesthetist stop the ventilation? 7-Mr Robson does not breathe spontaneously. Resuscitation has now been continuing for 30 min. What should his management be now? 8-Our previous analysis suggested that the most likely cause of his respiratory arrest was neurological. Hence, the most appropriate next investigation would be a computed tomography (CT) scan of his brain.
