Trial Short Case 1April 2023

Case Summary

60 year old female

2/52 post vaginal vault prolapse repair

GP referred in to ED with tachycardia 120/min and hypotension (SBP 90mmHg) with low SaO2 (low 90s on room air)

Background

Left breast cancer 2018 treated with radiotherapy

Hysterectomy

Dyslipidaemia

Medications

Nil regular

Examination

HR 105

BP 125/70

RR 15

Sp >94% 2-3L NP


Questions:

  1. What are the options for management in this case, and which one would you select?

  2. You end up doing a pulmonary embolectomy. Outline the steps of the operation.

  3. On attempted weaning from bypass, the right ventricle distends, and is functioning poorly.  Describe your management.