Presentation and Diagnosis

A 39-year-old para 1 patient is admitted to hospital for shortness of breath at 32 weeks gestation. She is an asthmatic and smokes 10 per day. She has a family history of deep vein thrombosis.

Her observations are:

  • Respiratory rate 28/min
  • O2 sats 90%
  • Heart rate 102 bpm
  • BP 96/50 mmHg
  • She is agitated
  • Temperature 37°C
  • Looks unwell

Look at the MEOWS chart for this patient (Fig 1) and summarize the observations in your summary table.

Question 1: Does your summary table look like this?

Answer

Zoom
Fig 1 MEOWS chart for case study 3

A 39-year-old para 1 patient is admitted to hospital for shortness of breath at 32 weeks gestation. She is an asthmatic and smokes 10 per day. She has a family history of deep vein thrombosis.

Her observations are:

  • Respiratory rate 28/min
  • O2 sats 90%
  • Heart rate 102 bpm
  • BP 96/50 mmHg
  • She is agitated
  • Temperature 37°C
  • Looks unwell

Look at the MEOWS chart for this patient (Fig 1) and summarize the observations in your summary table.

Question 1: Does your summary table look like this?

Question 2: Is this patient sick?

Answer

Answer 1: The MEOWS for this patient is:

White Yellow Red
Respiration 28/min
O2 sats 90%
Heart rate 102 bpm
Blood pressure 96/50 mmHg
Looks unwell Yes
Temperature 37°C
Total

A 39-year-old para 1 patient is admitted to hospital for shortness of breath at 32 weeks gestation. She is an asthmatic and smokes 10 per day. She has a family history of deep vein thrombosis.

Her observations are:

  • Respiratory rate 28/min
  • O2 sats 90%
  • Heart rate 102 bpm
  • BP 96/50 mmHg
  • She is agitated
  • Temperature 37°C
  • Looks unwell

Look at the MEOWS chart for this patient (Fig 1) and summarize the observations in your summary table.

Question 1: Does your summary table look like this?

Question 2: Is this patient sick?

Question 3: What do you think is going on?

Answer

Answer 1: The MEOWS for this patient is:

White Yellow Red
Respiration 28/min
O2 sats 90%
Heart rate 102 bpm
Blood pressure 96/50 mmHg
Looks unwell Yes
Temperature 37°C
Total 0 4 1

Answer 2: This patient is very sick and needs to be seen urgently.

A 39-year-old para 1 patient is admitted to hospital for shortness of breath at 32 weeks gestation. She is an asthmatic and smokes 10 per day. She has a family history of deep vein thrombosis.

Her observations are:

  • Respiratory rate 28/min
  • O2 sats 90%
  • Heart rate 102 bpm
  • BP 96/50 mmHg
  • She is agitated
  • Temperature 37°C
  • Looks unwell

Look at the MEOWS chart for this patient (Fig 1) and summarize the observations in your summary table.

Question 1: Does your summary table look like this?

Question 2: Is this patient sick?

Question 3: What do you think is going on?

Answer 1: The MEOWS for this patient is:

White Yellow Red
Respiration 28/min
O2 sats 90%
Heart rate 102 bpm
Blood pressure 96/50 mmHg
Looks unwell Yes
Temperature 37°C
Total 0 4 1

Answer 2: This patient is very sick and needs to be seen urgently.

Answer 3: She is unwell with high respiratory rate, heart rate and low blood pressure. She also has low oxygen saturation

Diagnosis: Pulmonary embolism or amniotic fluid embolism.

This patient needs urgent intervention-oxygen, HDU/ITU and steroids for baby.