A 41-year-old woman with known myasthenia gravis presents CTAS 1 with dyspnoea after pneumonia symptoms. She has weak cough, ptosis, RR 30, SpO2 93%,

Question

A 41-year-old woman with known myasthenia gravis presents CTAS 1 with dyspnoea after pneumonia symptoms. She has weak cough, ptosis, RR 30, SpO2 93%, negative inspiratory force is -15 cm H2O, and FVC is 12 mL/kg. What is the most appropriate next step?

Accepted Answer

Prepare for elective intubation and involve neurology and ICU urgently

Answer

Discharge after one dose of pyridostigmine

Answer

Delay airway planning until oxygen saturation falls

Answer

Use non-invasive ventilation and avoid ICU referral

Answer

Give magnesium sulphate for muscle weakness

Myasthenic crisis — RCPSC EM MCQ

A 41-year-old woman with known myasthenia gravis presents CTAS 1 with dyspnoea after pneumonia symptoms. She has weak cough, ptosis, RR 30, SpO2 93%, negative inspiratory force is -15 cm H2O, and FVC is 12 mL/kg. What is the most appropriate next step?