You are on your Emergency Medicine Rotation:
EMS brings a patient to the ED in respiratory distress. He is tachypneic, appears “out of it” and not able to give any information. His wife and 12 year old daughter accompany him in the ambulance. By retrieving his electronic records, you are able to piece together most of his medical history:
Henry Martino is a 45 year old male, with a history of hypertension and chronic obstructive lung disease (COPD) who was diagnosed with tongue cancer 14 months ago. He was treated with surgery, maximal doses of radiation, and chemotherapy, but his disease recurred. He now has local extension of his tumor, which has caused progressive dyspnea and stridor over the past month.
Recommended readings
Rondeau DF, Schmidt TA. Treating cancer patients who are near the end of life in the emergency department. Emerg Med Clin North Am. 2009 May;27(2):341-54.