treatment with sildenafil citrate for covid refractory hypoxia.

New Case 3 yr ,F, Alleged RTA , Two wheeler vs Two wheeler ,Pillion rider with out helmet ,unresponsive since RTA with left ear bleed on 14 th Jan at 6 PM.Evaluated locally ,intubated and mechanically ventilated due to poor GCS and then transferred. On exam pupils 2mm ,under the effect of sedation. Diagnosis and management. Already seen by Neurosurgeon and admitted under his care.

64 yo female. chief complaint of respiratory distress. Patient possessed history of type ll diabetes. Patient was on prescribed oxygen via nasal canula at 3.0 L/min. Patient was obese and appeared to have a mass in abdomen. No reliable source of pertinent medical history could be obtained on scene. Patient became unresponsive and was transported to hospital. 12-lead fluctuated greatly from sinus origin bradycardia at rates ranging from 27 bpm to 50 bpm. Patient was provided high flow oxygen and assisted in ventilation. vitals were observed as follows: blood pressure initially was 116/75 mmHg enrolled when reassessed blood pressure was 66/40 mmHg, pulse 30-50 bpm and sporadic, respiration of 8-12 cycle/min and labored with frothy sputum produced, pupils sluggishly reactive to light stimuli but equal, severely diaphoretic,blood glucose 339.0 mg/dl. intravenous access was obtained and 1.0 L was administered. 0.5 mg of atropine was administered with no change in rhythm. upon arriving at ER. Patient lost pulse and went asystolic. a " precordial thump" was performed by physician and a third degree heart block was observed. phydician ordered sodi bicarbonate, calcium chloride,zofran, and patient was started on dopamine infusion. none of these changed rhythm. Patient was externally paced and transported to cathartic lab. what do you think of 12-lead?

72 year old patient with left pneumonectomy due to lung cancer came with dyspnea and cyanosis to the emergency department. The patient had deep hypoxia (so2 50-60) unresponsive to oxygen therapy. The patient’s chest CT was evaluated as pneumonia? or interstitial fibrosis? He was admitted to the ICU. What you say for this case?

86/M Presented with ER in a unconscious and unresponsive state since 1.30am today a/w Vomiting 1 episode present. He was completely alright since 1.30am. H/O accidental skid and fall @ home 10days ago BP:150/100 HR:65/min Spo2:88%in RA GCS:4/15 CT Brain done Diagnosis and treatment??

A 38/M is brought to the ED with altered mental status. He was found on the ground in front of an apartment building unresponsive by neighborhood residents. His vitals signs are: rectal temperature, 85.4°F ; heart rate, 38/min; blood pressure, 88/40 mm Hg; and respiratory rate, 24 breaths/min. Finger pulse oximetry measurements were not successful. Physical examination is notable for limited response to vocal commands, rhonchi and dullness to percussion in the right lower lung field, delayed capillary refill, and blue fingers and toes. There are no focal neurologic deficits and no obvious signs of trauma. Routine blood work is within normal limits and a chest x-ray reveals consolidation in the right lower lobe consistent with pneumonia. An ECG is performed and is consistent with what principal diagnosis?