Question

A 70-year-old man with a 40-pack-year smoking history presents with increasing breathlessness and sputum purulence over 3 days. He has known COPD with FEV1 45% predicted. On examination he is using accessory muscles, respiratory rate 26 breaths per minute, oxygen saturation 89% on air and there are widespread wheezes. What is the most appropriate initial oxygen therapy strategy?

Accepted Answer

Controlled oxygen to target saturations of 88–92%

Answer

High-flow oxygen at 15 L/min via a non-rebreathe mask until saturations are 100%

Answer

Target oxygen saturations of 94–98% with nasal cannulae

Answer

No oxygen therapy because he has chronic lung disease

Answer

Use non-invasive ventilation immediately in all COPD patients

Practice question