Introduction

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Table of Contents

Introduction. 3

Discussion. 3

Conclusion. 6

Reference list 7

Introduction 

The clinical history and the study is related to the case of clinical deterioration of a male called Mr. Harry. He was a 72 years old person who came from an African background. At that time, the weight of the patient was more than 64.5 kilograms and he was about 165.5 cm tall. The patient is married and he has three children. In the previous time, Mr. Harry was a chain smoker. At that time, his wife lived with him. However, currently, Mr. Harry is an unemployed person. Here, the case study mainly presents various kinds of laboratory errors that caused unrecognised interferences previously.

Discussion 

The main reason for admitting Mr Harry into the hospital was respiratory failure. Mr Harry was presented with type one respiratory failure along with the septic shock that was secondarily attached to the whole lung system. The right side lung of the patient was attacked with pneumonia. At that time, Mr Harry was admitted to the Intensive Care Unit. There, the protocol was pushed to the patient to sedate him. Then methylprednisolone along with levofloxacin was given to the patient for post obstructive pneumonia. The arterial blood gas of the patient showed a pH 7.38 pCO2 38 pO2 143 on a Fio2 of 60 after initial intubation (Lambert, L. L., Baldwin et al., 2018). The level of HCO3 was measured and it was more than 25/5 meq/l for the patient. Over the next few days, it was found that the level of bicarbonate of the patient dropped progressively to 7.5 meq/litre although there was no change in the level of arterial blood gas of the patient. The anion gap of the patient was calculated by more than 18.5. The level of serum lactate of the patient was normal. On the other hand, the level of serum ketones was not present. After consulting with the department of pathology it revealed that the level of the serum of Mr Harry was lipemic. A review of a previous chart presented that the patient Mr Harry received various kinds of lipid infusion with TPN 36. It was received more than 17 hours before the discovery. A panel of lipids was obtained and the panel marked various kinds of hypertriglyceridemia at 4,426 mg/dl. Later it was seen that the lipid infusion levels were discontinued. Not only that but the protocol was absent and weaned off (Hemphill et al., 2019). However, the level of bicarbonate dropped to a minimum of about three meq/l. The treatment was discontinued after almost seven and a half hours. After four hours, it was seen that the level of bicarbonate had increased to more than 20.5 meq/l. However, the level of serum remained lipemic. As a result, the condition of the patient continuously declined. On the other hand, the level of septic shock was developed. This kind of septic shock led to various kinds of multiple organ failure as well as ventricular arrhythmias. The result of bronchoscope that was collected before presents various kinds of little cell carcinoma (Dallan et al., 2020). That is the reason other family members of the patient requested to stop this kind of aggressive treatment style. On the same day, the patient expired due to that aggressive style of treatment.

Figure 1: The rate of the septic shock of male and female

Source: (Dallan et al., 2020)

It is found from many types of studies that the main issues of the patient were septic shock, respiratory failure, morbidities and many more. Septic shock problem is a fatal medical problem that is found when sepsis. It can include various kinds of damaged organs that are damaged for different types of infection. It can lead the patient to dangerously low blood pressure along with various abnormalities that can be found in various cellular metabolisms. The third consensus of the international community defines septic shock as a subgroup of sepsis by which various kinds of metabolic abnormalities, cellular problems and circulator problems are found (Shebl & Burns, 2018). These can increase the mortality rate more than sepsis. Various patients that come to the hospital with the problem of septic shock can be identified easily by collecting a vasopressin in order to maintain the arterial pressure that is more than 64.5 mm Hg. Septic shock includes various kinds of risk factors for the patients. The septic shock can increase the risk of diabetes for the patient. It can attack the intestinal system of an individual and can create diseases. It can cause leukaemia and various long term use of antibiotics for current infections and many more. On the other hand, the disease of respiratory failure is another problem of the human body that can be created from the inadequate exchange of gases. The exchange of gases can be transmitted by the respiratory system of the human body. It means the arterial oxygen and the carbon dioxide can not be maintained at a normal level. A drop of the oxygen that is carried in the blood is called hypoxemia. A rise in the level of arterial carbon dioxide is hyper-capnia. The failure of the respiratory can be classified into two types. One of them is type one and the other one is type two that can be based on the level of high carbon dioxide or chronic and many more. The definition of respiratory failure says that respiratory failure can include respiratory rate, various abnormal gases of the blood and many more. The condition of respiratory failure can reduce the pressure of air level into the lung (Yildiz, 2020). It can include various kinds of foreign bodies’ physical instruction. It can reduce the pressure of breath due to various kinds of drugs. It can create different types of changes to the chest also. 

Conclusion 

Finally, it can be said that the patient Mr Harry was seen in the local hospital along with his wife. The general practitioner of the hospital noticed the respiratory failure of the patient. The patient visited another doctor one day before and conducted the report of CXR. However, the patient was admitted to the emergency department of the local hospital at seven am. He then transferred to the intensive care unit at nine am and a few hours later the patient was found dead. A clinical error is involved here and the doctors are responsible for that.

Reference list

Dallan, C., Romano, F., Siebert, J., Politi, S., Lacroix, L., & Sahyoun, C. (2020). Septic shock presentation in adolescents with COVID-19. The Lancet Child & Adolescent Health, 4(7), e21-e23. DOI: https://doi.org/10.1016/S2352-4642(20)30164-4

Hemphill, S., McMenamin, L., Bellamy, M. C., & Hopkins, P. M. (2019). Propofol infusion syndrome: a structured literature review and analysis of published case reports. British journal of anaesthesia, 122(4), 448-459. DOI: https://doi.org/10.1016/j.bja.2018.12.025

Lambert, L. L., Baldwin, M. B., Gonzalez, C. V., Lowe, G. R., & Willis, J. R. (2018). Accuracy of transcutaneous CO2 values compared with arterial and capillary blood gases. Respiratory care, 63(7), 907-912. DOI: https://doi.org/10.4187/respcare.05936

Shebl, E., & Burns, B. (2018). Respiratory failure. Retrieved from: https://europepmc.org/article/nbk/nbk526127

Yildiz, F. (2020). The Efficacy of Lung Volume Reduction Coil Treatment in Patients with Severe Chronic Obstructive Pulmonary Disease (COPD) Type II Respiratory Failure. International journal of chronic obstructive pulmonary disease, 15, 479. DOI: https://dx.doi.org/10.2147%2FCOPD.S218785