This case was immediately concerning and brought up a number of differential diagnoses. Having access to examination equipment allowed me to check the patient’s observations. His blood pressure was 170/134, his oxygen was 93% on air and his heart rate was 111bpm. Auscultation of his chest showed some quiet crepitations with decreased lung sounds in the left base. He was also able to demonstrate the pitting oedema of his ankles using the remote camera.
Using the examination equipment available I was able to assess the patient and appreciate the severity of his condition. Given his high blood pressure with low oxygen in a previously well young male, I felt that it was a matter of urgency to check his renal function and have a chest X-ray and ECG. Knowing that his oxygen saturations were low and his blood pressure was high with a tachycardia, this alerted me to the urgency of the case and I directed him to A&E for assessment.
If I had not had access to examination equipment I would not have been able to assess the patient. His symptoms were of concern immediately and it was obvious that he needed examination. Without being examined he would have needed to attend a surgery and his emergency management may have been delayed.