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    This document summarizes a mortality review of a 69-year-old female patient who presented with symptoms of shortness of breath, cough, fever, and history of tuberculosis contact. On admission, examination found tachycardia, fever, crepitations in both lung bases, and abnormal chest x-ray. Initial investigations showed leukocytosis and metabolic acidosis. She was treated for community-acquired pneumonia and possible tuberculosis with antibiotics and other supportive care. However, she was found unresponsive and in cardiac arrest the following day, with subsequent failed resuscitation. Blood cultures grew Streptococcus pneumoniae.

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    This document summarizes a mortality review of a 69-year-old female patient who presented with symptoms of shortness of breath, cough, fever, and history of tuberculosis contact. On admission, examination found tachycardia, fever, crepitations in both lung bases, and abnormal chest x-ray. Initial investigations showed leukocytosis and metabolic acidosis. She was treated for community-acquired pneumonia and possible tuberculosis with antibiotics and other supportive care. However, she was found unresponsive and in cardiac arrest the following day, with subsequent failed resuscitation. Blood cultures grew Streptococcus pneumoniae.

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    7 views8 pages

    Mortality Review: Medical Dept 2016 Hospital Miri

    Uploaded by

    afiqmm
    This document summarizes a mortality review of a 69-year-old female patient who presented with symptoms of shortness of breath, cough, fever, and history of tuberculosis contact. On admission, examination found tachycardia, fever, crepitations in both lung bases, and abnormal chest x-ray. Initial investigations showed leukocytosis and metabolic acidosis. She was treated for community-acquired pneumonia and possible tuberculosis with antibiotics and other supportive care. However, she was found unresponsive and in cardiac arrest the following day, with subsequent failed resuscitation. Blood cultures grew Streptococcus pneumoniae.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
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    of 8

    Mortality Review

    Medical Dept 2016


    Hospital Miri

    ID and Biodata

    Age: 69
    Sex: Female
    Address: LOT 458, pujut, padang kerbau
    Date of Admission: 28/1/2016
    Date of Death: 29/1/2016
    Cause of Death: sepsis secondary to CAP( ? PTB)

    Clinical Presentation
    69 years old lady, underlying hypertension,
    hyperthyroidism, IHD and SVT
    Presented with SOB for 1 day
    Cough for 3 days
    Difficult to expectorate sputum.

    Fever for 3 days


    No chills or rigors

    No vomiting, no diarrhea, no UTI symptoms


    History of PTB contact (husband)

    Examination on admission

    Concious, restless, mild pallor


    BP:140/64mmHg
    PR:170
    T:39.2c
    Spo2: 100% on high flow mask
    HEART: DRNM
    LUNGS: bibasal crepitation
    ABDOMEN: Soft and non tender
    No pedal oedema

    Investigations on admission
    ABG (on
    high flow
    mask)

    FBC
    WCC

    9.8

    urea

    24.3

    pH

    7.47

    Hb

    12.0

    creat

    93

    pCO2

    32.9

    Plt

    403

    Na

    133

    pO2

    89.3

    Hct

    37.2

    3.1

    Cl

    71

    RP

    HCO3 25.7
    BE

    0.4

    SO2

    96.5
    %

    CXR: perihilar
    haziness
    ECG: AF

    Initial management

    IVD 2.5l/day all NS


    IV augmentin 1.2g TDS
    IV azithromycin 500mg OD
    IV ranitidine 50mg TDS
    T carbimazole 20mg OD
    T rocalcitriol 0.25mg OD
    T caspirin 100mg OD
    T calcium lactate 600mg OD
    s/c clexane 60mg OD
    T simvastatin 20mg ON
    IV hydrocortisone 50mg TDS
    Ivi amiodarone 360mg for 6 hour, then 600mg over 18 hour
    i/o charting
    SPo2 monitoring

    Sent blood C+S, sputum AFB, sputum C+S, urine C+S, urine FEME, T4/TSH

    Progress in ward

    Noted patient unresponsive at 6.30 am.


    Pulse not palpable
    CPR commenced.
    DXT stat 1.1 mmol/l. 50cc D50 given
    However after 50 minutes, no chest rise,
    no heart sound, no pulse palpable,
    cardiac monitor show asystole and
    pronounced death at 0712h

    FBC

    RP

    28/1/2016

    29/1/2016

    WCC

    9.8

    12.3

    Hb

    12.
    0

    11.5

    Plt

    403 348

    Hct

    37.
    2

    LFT
    (29/1/2016)

    35.8

    TB

    19

    TFT
    (29/1/2016)

    DB

    T4

    44.9

    AST

    67

    TSH

    ALT

    29

    <0.00
    5

    ALP

    88

    TP

    59

    Alb

    25

    Glo

    34

    28/1/2016

    29/1/201
    6

    urea

    24.3

    20.6

    creat

    93

    76

    Na

    133

    142

    3.1

    3.3

    Cl

    71

    103

    Blood C+S
    (28/1/2016)
    Streptococcus
    pneumonia sp.

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