24-07-2025
THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HER SIGNED INFORMED CONSENT. HERE WE ISCUSS OUR PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY EXPERTS WITH AN AIM TO SOLVE THOSE PATIENT'S CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.
[24-07-2025 16:18] PPM 1: @PPM3 share her serial ABGs
[24-07-2025 16:33] PPM 1: [23/07, 17:22]cm: Looks like she could be having a pulmonary embolism!
A CT angiography now may help
[23/07, 17:28] Anonymous Pm: Why Pulmonary embolism?
[23/07, 17:29] Anonymous Pm: Why did her gcs deteriorate?
[23/07, 17:30] Anonymous Pm: I mean what in the 2d echo indicated that
[23/07, 17:30] Anonymous Pm: Dilated Pulmonary artery?
[23/07, 20:51]cm: RV appears more dilated than the first echocardiography
[23/07, 20:52]cm: Yes please update minute by minute on how it deteriorated
[23/07, 22:47] Anonymous Pm: Ok sir
[24/07, 08:40]cm: Was looking forward to it
[24/07, 08:43] Anonymous Pm: I'm sorry for the delay
[24/07, 08:44] Anonymous Pm: Basically when she came to op her higher mental functions were intact and gcs was 15/15
[24/07, 08:45] Anonymous Pm: Then yesterday morning around 4 am she developed headache
[24/07, 08:45] Anonymous Pm: At 6:30 am when we checked
[24/07, 08:45] Anonymous Pm: She was unable to name her attenders
[24/07, 08:45] Anonymous Pm: And was repeating things
[24/07, 08:45] Anonymous Pm: Then at 2 pm her gcs was around 12
[24/07, 08:45] Anonymous Pm: She also developed severe sob
[24/07, 08:49]cm: From the entire event looks like she had an ischemic stroke, also affecting her cortico diaphragmatic pathways, as noted by us in bedside ultrasound but unfortunately not captured on video.
Subsequently was the shortness of breath due to diaphragmatic palsy alone, it's difficult to say and is unlikely but it's more likely she developed a pulmonary embolism!
So essentially this disease made her develop thrombi at multiple arterial and venous locations.
A detailed history of when was she absolutely alright, and what were the events that led to her admission needs clarification.
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