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Dušnost, na místě muž 56 let,
AA: O, FA: antihypertenziva, PAD, detralex
OA: hypertenzní nemoc dle definice WHO, diabetik na PAD, před týdnem operace varixů na DKK
NO: zhruba hodinu pociťuje dušnost, bolest a tlak na hrudi, hlavně při nádechu, vykašlal menší množství krve
St.P.: sedící na křesle, při vědomí, orientovaný místem, časem, osobou, vyděšený, amengiální, neurologicky bez lateralizace, klidová dušnost, poslechově bpn, břicho nebolestivé, zvýšená náplň krčních žil, DKK bez otoků, je přítomna bledost a akrální cyanoza, pacient se profuzně potí
TK 90/60, P 130, D 28, SPO2 92%, glykemie 5,6 mmol/l, TT 38,9, na EKG sinusová tachykardie, zornice izo, foto ++
Pracovní diagnoza, léčba a směřování
Řešení:
vs PE/ stp. varixu DKK/ na transport iv vstup O2, v nemocnici CT angio-metoda volby- po potvrdení PE, v zavislosti od typu PE a kliniky-hosp. na intern. JIPe resp. ARO/Swan-Ganz-monitoring pri plicní hypertenzi/, trombolytická th-Trombolyza dle schemy ev embolektomie+antikoag. th.

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