In message <[log in to unmask]>, Bill Bailey
<[log in to unmask]> writes
>the 1st speaker advocated as much
>oxygen as possible initially with a reduction as more clinical information
>became available in A&E with ABG analysis, CXR etc. The 2nd speaker became
>very agitated when this was suggested after his lecture and claimed such
>treatment kills more elderly patients with COPD via hypercarbia and acidosis
>than the Bubonic Plague did in the Middle Ages.
This subject was covered previously on the list (check the archives on the web
site).
I side with speaker number one and certainly encourage our SHOs and nurses to give
high flow O2 initially but INSIST they do gases and clinically monitor patient
carefully after. Hypoxia is common and kills in minutes, CO2 retention is rarer and
gives you time to detect and correct it. We've not had any complaints from our very
supportive respiratory physician, yet!
I turn green, split my shirt and become unecessarily violent if called to a patient
with crashing LVF / IHD / Pneumonia (delete as applicable) with a 24% venturi mask
covering deeply cyanosed lips, the excuse being "They MIGHT have COPD at their age"!
Dr G Ray
Staff Grade
A&E
Sussex
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