what would your decision be if a COPD patient suffered from smoke inhalation? i know that for a regular person, you would put the patient on a 100% non-rebreather (if there is no hyperbaric chamber around). but in my head, im still debating on what to prioritize when it comes to COPD. if we put the patient on 100%, this can trigger hypoventilation because of air-trapping, but if we don't put them on 100%, he can suffer from carbon monoxide poisoning.
what would your decision be? in school, i was taught that ventilation comes first before oxygenation. i just thought this topic is worth debating about... it's acute versus chronic.
2006-09-12 06:28:13 · 5 answers · asked by Anonymous in Health ➔ Diseases & Conditions ➔ Respiratory Diseases
RRemember that COPD encompasses several chronic conditions such as asthma, bronchitis and emphysema. The only sub-group of COPD'ers that this would really be an issue with is that group of patient's that are near end stage the CO2 retainers. Air trapping would only be an issue after approx. 48 hours due to nitrogen washout resulting in atelectasis.
Because of the CO2 affinity for the hemoglobin providing a high concentration of O2 is necessary in cases of carbon monoxide/carbon dioxide poisoning associated with smoke inhalation (other issues heat trauma, toxic fumes, etc.). So a high concentration of O2 over rules the possibility of hypoventilation. If the patient isn't oxygenated you can pump all the air into the lungs you want but without freeing up the hemoglobin through some method (hyperbaric, positive press. ventilation or high O2 concentration) just plain ventilation isn't going to do the patient any good.
2006-09-12 10:08:09 · answer #1 · answered by Craig D 1 · 0⤊ 0⤋
that might be why you are the therapist and not the doctor.
I suspect that a pulmonologist would insist on 100% oxygen via non-rebreather for one hour out of every four, for a severe COPD pt.
2006-09-12 14:32:32 · answer #2 · answered by essentiallysolo 7 · 0⤊ 0⤋
In theory, you would try at all costs not to put a COPDer on 100%. But in this case, I would say to still put them on it. You need to treat the problem at hand.
2006-09-12 21:03:07 · answer #3 · answered by CJBig 5 · 0⤊ 0⤋
you have to go with the nrb. first things first.
2006-09-12 15:46:50 · answer #4 · answered by kurleylovescheese 6 · 0⤊ 0⤋
... shouldn't you be reading the Fundamentals text book? -_-"
2006-09-12 13:53:14 · answer #5 · answered by Anonymous · 0⤊ 0⤋