FOUNDATIONS OF CRITICAL CARE

Foundations of Critical Care

Foundations of Critical Care

The paper addresses a case study of 15 year old male who has been found unrousable in bed for the last 48 hours with flu like symptoms and went to bed early complaining of a severe occipital headache. Patient's examination revealed the observations that he has Temperature is 39.1, P 155, BP 70/45, RR 36, Sats 93% in air and GCS - E1, V2, M4. Furthermore it has been noted that he has cold hands and feet and that his lower legs look mottled and have purple coloured blotches appearing.

Above mentioned all symptoms reveals that patient is victim of meningiitis with sepsis and he needs immediate critical care to save his life. For this purpose following points will be considered differential diagnosis in this patient, etiology and pathophysiology behind the symptoms and signs, treatment options in the pre-hospital environment, potential complications and course of this illness and the management options.

a. What is the differential diagnosis in this patient?

The death rate is 40%; that equates to 8 in 20 people (Bolton, 2005, 8-27). The rate of major amputation or loss of fingers/toes is about 20%; that is approximately 4 out of 20 people. These are the rates for those who receive treatment in time. The putrefactive destruction of tissue by disease-causing bacteria or their toxins (Bolton, 2005, 8-27). A form of shock that occurs in septicaemia when endotoxins are released from bacteria into the bloodstream. These toxins cause vasodilation, resulting in a dramatic fall in blood pressure and are a major contributing factor to the failure of the circulatory system (Bolton, 2005, 8-27).

The diagnosis of this extremely serious acute illness that occurs suddenly from full health without the typical symptoms is very difficult, almost impossible, to set up the first hours. The temperature is usually very high, and medications for lowering the temperature as, or other measures does not improve the situation. Neither blood tests at this stage of the disease does not reveal its nature (Craig, 2011, 63-109).

Observation of the child and the occurrence of red spots on the skin raises the suspicion of sepsis. This means that the bacteria entered the blood, all down to the smallest branch of blood vessels - capillaries which leads to blood clotting. This phenomenon - consumption coagulopathy (DIC - disseminated intravascular coagulation) leads to the consumption of blood platelets - platelet count and bleeding in the number of organs (Craig, 2011, 63-109). Most severe form of disease is bleeding in the adrenal glands.

The question about the source of infection which is not easy to detect, because people who are carriers of meningococcal disease (usually type B) are not sick, but the source of infection. The disease is rare, and its occurrence is more common in people who have a rare disorder in the system of defenses against infection (immunity). Immunological events in the body are very complex, and one of the components of the complement ...