SAQ 603 – Anaesthetics – COPD exacerbation and intubation decision

Marked out of 18.00

A 57-year-old male is brought to the emergency department by ambulance. He has a history of COPD and asthma, has smoked for 40 years, and continues to smoke. Ambulance officers found him severely short of breath and treated him with high-flow oxygen and continuous nebulised salbutamol en route.

The latest ambulance observations and ABG are shown below.

Observation Result
BP 160/80 mmHg
HR 140 bpm
RR 40 /min
O2 saturation 86% on high-flow oxygen
GCS 15
pH 7.12 (7.35-7.45)
pCO2 91 mmHg (35-45)
HCO3 30 mmol/L (22-26)
pO2 271 mmHg
Base excess -1 (-1 to 1)

State six (6) factors you would consider when deciding whether this man requires intubation.

(Marked out of 6.0)


/ 6

Interpret this ABG in the clinical setting. Include four (4) points.

(Marked out of 4.0)


/ 4

Would you intubate him on the basis of these gases?

(Marked out of 1.0)


/ 1

State three (3) justifications for your decision.

(Marked out of 3.0)


/ 3

If he progresses to intubation, state four (4) points describing the ventilation pattern you would initiate.

(Marked out of 4.0)


/ 4

Total Score: 0 / 18

Percentage: 0%

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