Clinical note · #58
Critical care
Patient: John Evans · MRN: 98745621 · Admission: 09/29/2024 · Critical care: 09/29/2024 · Attending: Dr. Sarah Lewis
Primary diagnosis: acute respiratory failure due to COVID-19 pneumonia. Secondary diagnosis: acute kidney injury.
Hospital course
John Evans, a 62-year-old male, was admitted with acute hypoxemic respiratory failure secondary to severe COVID-19 pneumonia. His oxygen saturation dropped below 85%, and he developed tachypnea and increased work of breathing. He was immediately intubated and placed on mechanical ventilation. Initial settings included high levels of positive end-expiratory pressure (PEEP) and FiO2 of 100%. Despite these interventions, Mr. Evans experienced persistent hypoxemia and required prone positioning to improve oxygenation. Continuous monitoring of arterial blood gases and ventilator settings was performed, along with sedation and paralytics to facilitate oxygenation. Total time spent during the critical care service was 135 minutes.
Key interventions
- Intubation and mechanical ventilation: needed 5 minutes to perform
- Prone positioning for ARDS
- Arterial blood gas monitoring
- Sedation and paralytics
Condition: remains critical, sedated and ventilated. Close monitoring of ventilator settings and arterial blood gases continues.