Respiratory · case mode
SpO2 99% and getting drowsy
A 70-year-old with severe COPD arrives by ambulance on 15 L/min oxygen via a reservoir mask. He is drowsy with a flapping tremor. SpO2 99%, respiratory rate 12/min, pH 7.21, PaCO2 9.4 kPa, PaO2 24 kPa, bicarbonate 32 mmol/L.
- 1
What is the single most important immediate change?
- 2
What drug treatment accompanies the oxygen change?
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- 3
After one hour on controlled oxygen and full therapy the gas shows pH 7.24 and PaCO2 8.9 kPa. What now?
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- 4
He improves on NIV over 24 hours. What must the discharge package include?
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