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ACUTE CHESTSYNDROME

Andre Coleman, (Almost) M.B.B.S.

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CASE31 ear old !la"# male $%t& H! SS

'C

'a%n "r%s%s*

H'C'a%n %s %dent%"al to t+%"al +a%n "r%s%s.

'a%n started esterda and &as not res+onded toanales%"s.

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CASE'MHA-as"lar ne"ros%s o/ !ot& &%+s, +r%a+%sm, NSTEM0,"&ole"ste"tom, one +r%or &%stor o/ A"te C&estSndrome (ACS).

%s%ts ED on"e e-er mont&

SH

Smo#es "%arettes

Dr%n#s !eer o""as%onall

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CASEO!ser-at%on and E2am%nat%on

Tem+ 44.5 6C B' 113758 'lse 497m%n RR :;7m%nO: 43< on room a%r

'at%ent %n res+%rator d%stress

M%ld "on=n"t%-al %"ters

A!domen so/t $%t& d%>se tenderness

Tender o-er !ot& &%+s and lateral t&%&s

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CASEEmeren" De+artment "orse

O:/ell to 9;< a/ter +a%n med%"at%on

O:res+onded to o2en t&era+

?e#o"tos%s @BC 1,;;;

Haemolo!%n 9.4 (!asel%ne)

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CASE'at%ent %s adm%tted to $ard

T&e ne2t da &e !e"omes ta"&+ne%" andta"&"ard%"

O2en re%rements %n"rease

Trans/erred to 0CU

Re"e%-es o!ser-at%on and e2"&ane trans/s%on

D%s"&ared a/ter da 1;

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Diagnosis???

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ACUTE CHEST

SYNDROMEAcute A"te "ard%o+lmonar sm+tom

'?US

Chest Ne$ +lmonar rad%ora+&%" %nltrate

Syndrome Com+le2 and mlt%/a"tor%al +at&oenes%s

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S0C?E CE?? D0SEASEHered%tar &aemolo!%no+at&

Reslts %n a!normal red !lood "ells t&at s%"#lender +oor o2en tens%on

S%"#led red "ells "an o""lde !lood -essels andd%sr+t !lood s++l

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E'0DEM0O?OFYSe"ond most "ommon "ase o/ &os+%tal%Gat%on

Res+ons%!le /or :8< o/ deat&s /rom S%"#le Cell D%sease

Most "ommon %n t&e :I ears ae ro+

Mortal%t rate o/J1< /or "&%ldren + to 4s e-er : &ors $&%lea$a#e

0m+ro-es -ent%lat%on"om+rom%sed ! o+%o%ds

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TRANSUS0ON THERA'Y0nd%"at%on determ%ned "l%n%"allCons%der /or

H+o-olem%a

H+o2em%a

Mlt%lo!ar +nemon%a

Do not e2"eed H! o/ 1; 7d? or &emato"r%t o/ 38