72 M SRI CHAKRA

  Osce questions What is the criteria for weaning off patient from ventilator? Subjective assessment:      Adequate cough      No neuromuscular blocking agents       Absence of excessive trachea bronchial secretions       Reversal of underlying cause of respiratory failure       No continuous infusion of sedatives Objective assessment:      Stable cardiovascular status      Heart rate <140 beats/min      No active myocardial ischemia       Adequate heamoglobin level >8g/dL      Systolic blood pressure 90-160mmHg     Temperature-afebrile   Adequate oxygenation:       Tidal volume >5mL/kg       Vital capacity >10mL/kg       Proper Inspiratory effort        Respiratory rate <35/min       PaO2 >60mmHg, PCO2 <60mmHg       No significant respiratory acidosis        Peep (positive end respiratory acidosis) < 8 cmh2O       O2 saturation >90% on FIO2 <0.4 How to differentiate between bronchial breath sounds and normal vesicular breath sounds? Normal vesicular breat

  This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent.  Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan. A 83yr old male came with complaints of  shortness of breath since 17 days. chief  complaints:  cough since 20 days Fever since 19 days shortness of breath since 17 days History of Presenting illness: Patient was adm