Medical Question on COPD?

Question

If there is Advanced COPD and the individual is constantly being put on and taken off of the Vent. The hospital has said that they do not check blood gasses unless there is a need to. Shouldn't they check them regularly since the person's body is not getting rid of the CO2?? any help before we go yelling at the nurses..I am looking for doc, and nurse answer

Answer 1

At the hospital I work at, we do blood gas analysis on every patient on a vent, every day. It is important to check blood gas results if we are controlling someones respiratory drive. PaCO2 is the best indication of ventilation. It needs to be monitored.

That said, we do have (and are using) an end tidal CO2 monitor on some patients. It's like a pulse ox but reads the amount of CO2 that is exhaled through the breathing tube. This number is consistent with blood gas numbers.

Please don't yell at the hospital staff. If you have a question, ask to see the on duty supervisor and/or the doctor.

Good luck

Answer 2

Why would you yell at the nurses? Did you know the docs have to write the orders? Have you spoken with the insurance company or payor source? Will they pay for blood gases when they aren't needed?
An experienced nurse, doctor or respiratory therapist knows how to recognize when a person is having a problem. It's not necessary to draw gases regularly, unless the patient is being weaned.

It sounds as though you want the person to live on the ventilator. If that person has advanced COPD, and has to be put off and on a ventilator constantly, have any of you considered hospice? There is no cure for advanced COPD. Perhaps it's time to consider that the quality of life for that person is terrible, and they may be tired of it all. Hopefully someone has approached the subject, and hopefully you will be willing to do what is right for that patient. Maybe that's part of your frustration? I wish you peace and luck; it's a stressful, sad situation.

Answer 3

If a patient is on a vent, blood gases are usually checked when making vent changes such as when a pt's condition is getting better or worse & just prior to extubation to be sure the pt is in good enough shape for the tube to be pulled (also weaning trials are done at this time). When a patient is off the vent, blood gases are usually only done when indicated (ie. a deteriorating respiratory status and poor level of consciouness). Copd pt's often retain co2 and usually live witth higher co2 levels & lower oxygen levels than the rest of us, so even if the gases were checked regularly most often the result would be an abnormal high reading. However as long as the patient is awake/alert and breathing on his/her own you would not want to reintubate(put them back on a vent) them. Unfortunately this is really the only way to significantly reduce co2 levels in an advanced copd patient. I hope this sheds some light on the matter for you.

Answer 4

There is no need to check unless there is a symptomatic problem. When first going on the vent or weaning off, gasses are checked more frequently but the modern monitoring devices are adequate measurements along with assessing the patient. You know, some things even a vent can't cure, it can only resore as lung function permits.
Please don't yell at the nurse.

Answer 5

I'm an RN, and I worked in an intensive care unit for 5 years. I hate to be blunt, but you need to know that if your loved one ever gets off the ventilator, it will be a miracle. Once someone is sick enough to require one, there is no getting better. I'm telling you this because no one at your hospital will say it to you. Or maybe they have and you don't want to believe it. COPD is a progressive disease that does not get better.

The job of the doctors and nurses now is to keep your loved one as comfortable as possible. You need to let them do their job. Doing blood gases on a routine basis is not the usual practice. They are done when vent changes are done or when the patient demonstrates a repiratory distress, and believe me, they are able to discern when that happens.

I know you are just sounding off here because you are frustrated and feel hopeless. Trust your health care professionals and work with them, not against them. Enjoy the time you have left with your loved one. God bless.

Answer 6

Perform blood gas only when needed,more blood gas... done don't help to get rid of more co2 in the blood.This is need order from the doctor and perform by pulmonary. technician and is not the nurses job and this procedure is painful,need to puncture to a artery.Please don't yell to the nurse.

Answer 7

Yes, DON'T YELL AT THE RN's.
They are your caretakers and are there to help not hurt.
Monitors give the information that is needed about a person's CO2 level. When
that number shows a significant decrease it is then that the Doc is notified and a blood gas is ordered.

Answer 8

an oxygen saturation monitor can be done constantly . that is enough . blood gases do not need to be done all the time .
i have had them in the ER bang bang bang as fast as they could do them and kept doing them for quite awhile you don't want the person to go though that it hurts.