Hypoxia in a Patient With No Cardiac or Pulmonary History


Case Study

A rapid response event was activated by the bedside nurse for a patient who developed respiratory distress and required increasing oxygen supplementation. On arrival of the condition team, the patient was visibly dyspneic and using accessory muscles of respiration. Per the bedside nurse, the patient was a 40-year-old male with a history of hypertension and diabetes mellitus who was admitted to the hospital for treatment of community-acquired pneumonia. The patient was admitted with oxygen supplementation of 4 L via nasal cannula and treated with ceftriaxone and azithromycin.

Vital Signs

  • Temperature: 98.3 °F, axillary

  • Blood Pressure: 130/90 mmHg

  • Pulse: 120 beats per min – sinus tachycardia on telemetry

  • Respiratory Rate: 32 breaths per min

  • Pulse Oximetry: 85% on 4 L, 95% on 15 L non-rebreather

Focused Physical Examination

A quick exam showed a middle-aged male who appeared visibly dyspneic, using accessory muscles of respiration. The patient was unable to speak in complete sentences. On auscultation, significant crackles and rhonchi were present in bilateral lung fields. His cardiac exam revealed regular rhythm and tachycardia. No murmurs or added heart sounds were identified. The remaining physical examination was unremarkable.

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