Nepean Hospital

  • 62-year-old female, with a long-term tracheostomy for airway patency following CVA, admitted to ICU two weeks earlier with hypoxic respiratory failure. Clinical signs included morbid obesity, reduced breath sounds bibasally, left pleural effusion, atrial fibrillation and right hemiparesis. Candidates were asked to assess her with respect to her failure to wean. Other points for discussion included interpretation of CXR, management of AF, CCF and infection, nutritional support and the plan should weaning be unsuccessful.