Ny flyvning for SOS. Nedenunder finder i medicinsk info:
Short medical history:
Pt is known with atrial fibrillation.
Pt has got fever last week. She did not want to go ti the hospital. On 5th, the pt was very ill. They called ambulance. Pt has been admitted on 5th May. Pt has been diagnosed with Bacterial endocarditis of Aortic valvule. no bacterie identified. Pt has then been discharged on 10th May. Readmitted yesterday.
SatO2 98% in 30L, BG mildly high. Dobutamine and dopamine infusion is, lasix, anticoagulation. pt gets vancomycin, gentamycin, digoxin, metroprolol,
Pts TD has gone home from 24h shift. pt is left to nurse in charge to take care of her. There are no other doctors on the unit. This hospital is second best in Albania. They have cardiac surgery. TD has contacted Tirana. The pt was not stable to be transferred to Tirana.
I explained to Bobby that the pts condition is severe. The pt is in life danger. She may die with or without adequate care. The pt is not treated appropriately in the hospital. And the pt is not stable for AFY.
If AFY dr accepts the pt for transfer., she will most llikely require intubation and several hours of stabilisation before transferring (if she survives that part). I will talsk with med sup. Pt will probably require intubation, ventilation, iv fluid treatment, changing Dopamine and Dobutamine to Adrenaline and Noradrenaline, adding Meropenem to antibiotic cover. Pt will probably require several hours of stabilisation before the transport.
Pts family is informed that the pt may die with and without adequate treatment as well as during the transport. They accept the risk.
Breathing /ventilator settings:
HFO 20L SatO2 98%
Dobutamin and Dopamine
Blood pressure: 80.0 / 50.0 mmHg
Pulse: 80.0 beats/min
Respiratory rate: 24.0 breaths/min
Oxygen saturation: 98.0 %
Temperature: 37.0 Co