Clinical Scenario
A 80 yo nursing home resident woman is brought to the ED by ambulance.
“Hypothension, cough and a hystory of heart failure ”, refers the nurse.
She looks pale and confused, her respiratory rate is 22, oxygen saturation on room air is 90%. Ear temperature is 36,5°C, BP is 90/60 mmHg, HR is 95.
There’re pulmonary rales. Lactate are 4 mmol/dl.
Is it a low flow heart failure or is there and underline pneumonia? Does the absence of fever rule out bacteriaemia?
