A 79-year-old woman in a care home becomes acutely confused and drowsy. She has a history of heart failure and is on Ramipril, Bisoprolol and Frusemid...

Question

A 79-year-old woman in a care home becomes acutely confused and drowsy. She has a history of heart failure and is on Ramipril, Bisoprolol and Frusemide. Her observations show BP 82/48 mmHg, pulse 104/min, respiratory rate 26/min, saturations 94% on air, temperature 37.1°C. Capillary glucose is 5.2 mmol/L. What is the most appropriate immediate management in the care home before transfer?

Accepted Answer

Call an ambulance and commence ABCDE assessment with oxygen and IV fluids if trained staff available

Answer

Lie her flat and give large volumes of oral fluids

Answer

Start high-dose Prednisolone and observe

Answer

Withhold all medications and review in 24 hours

Answer

Give subcutaneous insulin and refer urgently

uk-plab-1 MCQ (SBA): Deteriorating older patient with shock