Acute medicine
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Surviving Sepsis Campaign (SSC) recommendations highlight the importance of a 6 hour resuscitation care bundle, to be commenced in the initial assessment area. The aim of this survey was to collate information from Acute Medical Units nationally in order to assess their ability to implement the 6 hour resuscitation bundle.
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An 86 year old woman with a background of hypertension and arthritis presented to our medical assessment unit with 3 weeks history of mild dyspnoea and central chest discomfort. She did not have any past history of respiratory problems. She denied any cough, hemoptysis or weight loss. ⋯ She was a life long non smoker and used to drink alcohol occasionally. She was taking enalapril 5 mg and amlodipine 5 mg daily. She was living alone and was independent and self caring.
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Acute hypercapnic respiratory failure in chronic obstructive pulmonary disease can usually be managed initially with medical treatment and non- invasive ventilation. In circumstances where non- invasive ventilation cannot be used or has failed, intubation and invasive ventilation may be lifesaving. ⋯ Decisions regarding invasive ventilation made by physicians and patients with COPD are unpredictable and vary with the individual. This article reviews the role of invasive ventilation in exacerbations of COPD to assist decision making.