MRCP2-4171

MRCP2-4171

You are requested to assess a 77 year-old male patient who is currently admitted to the respiratory ward for an infective exacerbation of pulmonary fibrosis during your night shift. The patient has a medical history of end-stage renal failure due to type 1 diabetes mellitus and is dependent on haemodialysis. He has previously discussed his escalation plan and has declined ICU admission or CPR in the event of a cardiac arrest.

Upon reviewing his chest X-Ray, you observe extensive consolidation on the left side. The patient has been receiving high flow oxygen and intravenous antibiotics for the past few days, but the nursing staff reports a deterioration in his condition over the last 24 hours. During your examination, you notice that the patient is in distress and experiencing dyspnoea, with oxygen saturation levels of 72% on 80% high flow humidified oxygen.

What would be the appropriate course of action in this situation?