Mixedadvanced8 min
The sat step-up
Handover
A 28-year-old ‘athlete’ with a loud fixed-split S2 and a PA sat of 86%. No fever. CO by thermodilution is 7.8. That is not great cardiac output — that is arterial blood arriving in the RA. Run the sats before you invent a new cardiomyopathy.
Untreated tamponade, massive PE, or a crashed CPO/PAPi will keep dropping MAP and climbing lactate. Name the tracing, then move.
Goals
- · O₂ sat run done
- · Step-up localized
- · Echo confirms shunt