In-Reply-To: <000e01bf88d6$84d51840$7b518cd4@default>
Yes, I agree with Judith's view. Chronic airways disease is a slow melting
of lung tissue, and does not present acutely - what you get are acute
bacterial or viral exacerbations, and despite Moore-Gillon's letter to the
Lancet in 1979 that started the row when he told of patients arriving at
hospital comatose because their oxygen drive had been compromised, it
really isn't a problem clinically - patient has oxygen, becomes sleepier
and more lethargic so you take the mask off again - they wake up. Then you
know they are using oxygen drive. More people suffer chronic hypoxia
prehospital and in hospital because of fears about a tiny group of
patients (who are likely to die shortly anyway) than from any other single
cause.
Once they get to A&E a blood gas analysis will rapidly settle the matter.
Best wishes,
Rowley Cottingham
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