What is the most likely cause of the patient’s respiratory distress?

You are transporting a 48-year-old male patient between medical facilities…

During the history, you learn that the patient was involved in a fall at work and suffered a hip fracture and a head injury. The patient is now presenting with labored breathing at 30/min that has progressively worsened over the last 24 hours, a heart rate of 104, and a blood pressure of 98/70. On auscultation, you hear diffuse rales. The patient denies any complaints of pain other than those related to his recent fall.

What is the most likely cause of the patient’s respiratory distress?
A . Cardiogenic shock
B . Congestive heart failure
C . Acute bronchitis
D . Adult respiratory distress syndrome

View Answer

Answer: D

Explanation:

Adult respiratory distress syndrome involves non-cardiogenic pulmonary edema that presents 12­72 hours post injury or surgery. Congestive heart failure and cardiogenic shock, while they may occur from the ARDS, have an initial cardiac compromise. Flash pulmonary edema has a rapid onset and deterioration over as little as 30 minutes and is associated with renal dysfunction.