What are the rest of his vital signs? What is his usual BP? How does he feel? Was this found on routine vital sign check or is something wrong?

•What are the rest of his vital signs?•What is his usual BP?•How does he feel? Was this found on

routine vital sign check or is something wrong?

• Cardiac: –Tachyarythmia –Bradycardia –MI• Physiologic: –ESLD, CHF –Young and asleep• Sepsis• Meds• Hypovolemia: –Dehydration –Bleeding

•See the patient•Call your resident; Call MICU•Recheck vital signs, check

orthostatics•IV Fluids•Get Access•Consider EKG, CBC, T&S, Broad

spectrum ABx

•What are her vital signs?•How do her lungs sound?•What are her IV Fluids?

•Reactive Airway Disease/COPD•PE•Cardiogenic –MI, CHF•Too much IV Fluid•Pneumonia•PTX•Anxiety

•Examine patient –listen to lungs, JVP, LE Edema

•CXR•EKG; cardiac enzymes•ABG•I/Os•On DVT prophylaxis?

•Oxygen•Diurese•Chest CT r/o PE•Nebulizer/BIPAP•Head of bed up•Nitro•Call resident

•What are his vital signs (check both arms)?

•How does he look?•When did it start?•Get an EKG

•MI/aortic dissection•GERD•PE•Anxiety•MSK•Pneumonia; cholecystitis; pancreatitis•Pericarditis

•Evaluate patient•Treat as angina-tele, ASA, B-blocker, nitro,

serial CKs, heparin, tell resident•Treat as GERD-mylanta•Treat as MSK-ibuprofen•Treat as anxiety-reassure; ativan?•Treat as PE –chest CT, heparin?, oxygen Treat as dissection – CT chest, control BP