Case 4

 
Lobar pneumonia.jpg

An 80 year old man presents to the ED complaining of 4 days of chesty cough productive of green sputum, anorexia, malaise and fevers. He has a past history of Hypertension, hypercholesterolaemia and ischaemic heart disease with previous CABG. He was discharged from hospital 1 week ago following a 5 day admission with an NSTEMI which was medically managed.

His observations are as follows;

Temp 38.9, RR 24, Sats 90% RA, HR 102, 155/87

His Chest x-ray is opposite.

 

Question 1

What is the diagnosis?

Question 2

How do you calculate the severity of this condition?

Question 3

What therapy do you initiate in ED?