Possibly. I tried it with 5cm of AP on an elderly lady with severe primary respiratory failure - had a URTI for a few days treated by the GP with
antibiotics, seemed to be getting better and then found unresponsive by husband. Gases on admission were pO2 of 7 (all units kPa) and pCO2 of 12,
and when we asked for an ITU bed EBS told us that there were none in the country. So the earlier posting (and this is on a different day) about
Calais was correct. To my eternal shame, the thought flashed through my mind that perhaps we could simply treat conservatively. No, this patient
needed treatment, and Government-imposed quotas weren't going to stop me. So I tried CPAP, and once we had got a seal, monitored her gases. I
was quite encouraged when her oxygen got to 8.55, but not so happy when I realised that the pCO2 was 20.5! No option but to intubate and
ventilate. The lady was sent to HDU on a theatre anaesthetic machine to ventilate her! And two hours later we had a man in with a Barnsley chop -
so he needed ventilation too...
I realise that a series of one is of anecdotal interest only, but it didn't seem to be able to help her increasing tiredness (not to mention the CO2
narcosis!) enough . Interestingly, it only took half-an-hour on IPPV for her gases to recover dramatically.
Best wishes,
Rowley Cottingham
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