ABSTRACT
History You are the surgical F1 called to the ward by the nursing staff. They are concerned about a 75-year-old patient in respiratory distress and have asked you to assess him immediately. He initially presented to hospital 11 days ago with a perforated duodenal ulcer. He was operated on within 24 hours having had an omental patch repair. Postoperatively, he had been progressing well, but recovery had been prolonged due to poorly controlled pain. He has a past medical history of hypertension and chronic kidney disease. The following medications are listed on his drug chart: enoxaparin 40 mg/day, oramorph 10 mg 4 hourly, ramipril 10 mg/day, paracetamol 1 g four times a day, as required oramorph 5 mg up to 2 hourly, intravenous fluids prescribed 8 hourly.
