Author: Charlotte Davies / Editor: Yasmin Sultan / Reviewer: Caitriona Considine, Charlotte Davies / Codes: / Published: 07/06/2023
A 69-year-old with known COPD attends your emergency department (ED) very short of breath. They have been placed in the resuscitation room, and your FY2 is seeing them. Their sats are 88% on 40% of oxygen via a venturi mask. They have received three salbutamol nebulisers, and one ipatropium via the ambulance service with no improvement.
They are visiting relatives, so are not known to your respiratory services. Your FY2 shows you the ABG (below) and CXR (below) and asks you what to do next.
ABG on 40% O2: pO2 10 (75mmHg), pCO2 8 (60mmHg), pH 7.01, BE -2, Lactate 2.5
