طب الطوارئ والتخدير

A 70-year-old man is found unresponsive at home. The emergency medical technicians note his blood pressure to be 70 mm Hg by palpation. His pulse is 120/min. He is brought to the emergency department, where his temperature is 39.5 C (103 F), and respirations are 30/min. He has rales halfway up his chest. Heart sounds are inaudible. His urine output is 10 mL/h. A chest x-ray film reveals fine costophrenic septal lines, and an electrocardiogram shows sinus tachycardia. He is given antibiotics and is taken to the intensive care unit, where a right-sided catheterization shows an elevated wedge pressure and diminished cardiac output. His right atrial pressure is not elevated.