The electronic pulse oximeter is in use and, although you would rather not do it, you take the patient’s pulse manually. while counting the pulse you notice it seems irregular and every so often it seems to feel stronger. you look at the patient who appears pale and has a slight grimace on his face. what should you do?

The first thing you should do is to check all vital signs (blood pressure, heart rate, respiratory rate, temperature) refer to the physician in charge of the patient. In this patient who looks pale with a slight grimace on general survey, with irregular and bounding pulses, the differential diagnoses with be: (1) cardiac pathology, (2) hemorrhagic shock, or (3) severe anemia. The attending physician shall be informed immediately for the proper management to be ordered.

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