Case 3
A 76 year old man attends the Emergency Department with a 3 day history of worsening shortness of breath. He has also noticed a worsening, productive cough with green sputum and was having fevers and chills.
His past medical history includes COPD, hypertension, dyslipidaemia and previous prostate cancer. He is a lifelong smoker and currently smokes 15 cigarettes per day.
On examination, there is an audible wheeze from the bedside, he is tachypnoeic at 28 breaths/minute, tachycardic at 105 beats/minute, SpO2 is 84% on room air.
His arterial blood gas is shown opposite.
Question 1
What are the differential diagnoses for this patient?
Question 2
What does the ABG show?
Question 3
What is your immediate management?
Question 4
What investigations would you perform?