Acute Pulmonary Oedema: A 74-Year-Old Woman in the ED
A branching clinical case simulation for a patient presenting with acute breathlessness. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 4medium20 min6 stages
- Patient
- 74 years, female
- Presenting complaint
- Acute breathlessness
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment, Monitoring
The presentation
You are a fourth-year medical student in the ED of a district general hospital. An ambulance has brought in Margaret Whitfield, a 74-year-old woman, with severe breathlessness. She is sitting upright, using accessory muscles, and is sweating. Her SpO2 is 84% on air. Her husband says she has a history of ischaemic cardiomyopathy. You need to act quickly.
What this case teaches
Recognise acute decompensated heart failure; sit up, oxygen, intravenous loop diuretic and nitrate where blood pressure allows; identify the precipitant; monitor response.
How the case unfolds
- 1Focused HistoryHistory
- 2Immediate ExaminationExamination
- 3InvestigationsInvestigations
- 4Working DiagnosisDiagnosis
- 5Immediate ManagementTreatment
- 6Monitoring and ReassessmentMonitoring
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
Log in to run "Acute Pulmonary Oedema: A 74-Year-Old Woman in the ED"
A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
Taught in
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.